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General NPI Number Information
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NPI Number | 1124393988
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Entity Type | Individual
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Provider Name | NANCY SYPOLT RNFA
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Gender | Female
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Dates
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Enumeration Date | 03/13/2012
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Last Update Date | 03/13/2012
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Provider Practice Location Address
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Address Line | 2460 WESTWOOD DR
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-8271
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Country | US
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Telephone | 386-274-5712
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Fax | 386-274-1926
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Provider Business Mailing Address
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Address Line | 2460 WESTWOOD DR
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168-8271
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Country | US
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Telephone | 386-274-5712
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Fax | 386-274-1926
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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 | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | RN9179484
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License Number State | FL
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