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General NPI Number Information
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NPI Number | 1104684331
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Entity Type | Individual
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Provider Name | SELMA RAPHAEL
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Gender | Female
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Dates
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Enumeration Date | 03/12/2024
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Last Update Date | 11/04/2026
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Provider Practice Location Address
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Address Line | 1501 MAPLE AVE STE 300
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City | RICHMOND
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State | VA
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Zip | 23226-2553
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Country | US
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Telephone | 804-287-7878
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Fax |
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Provider Business Mailing Address
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Address Line | 1828 FLOYD AVE
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City | RICHMOND
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State | VA
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Zip | 23220-4514
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Country | US
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Telephone | 804-339-9690
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0024197885
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001311662
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License Number State | VA
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