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General NPI Number Information
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NPI Number | 1093413825
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Entity Type | Individual
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Provider Name | ERIN E RENAUD
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Gender | Female
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Dates
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Enumeration Date | 02/21/2023
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 303 SE 17TH ST STE 309
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City | OCALA
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State | FL
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Zip | 34471-4423
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Country | US
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Telephone | 352-221-1574
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Fax |
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Provider Business Mailing Address
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Address Line | 15451 NW 10TH AVE
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City | TRENTON
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State | FL
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Zip | 32693-8278
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Country | US
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Telephone | 352-221-1574
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11024567
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License Number State | FL
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