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General NPI Number Information
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NPI Number | 1154596526
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Entity Type | Organization
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Legal Business Name | VICKI JO CARRIER INC
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 105 HALF MOON CIR #A-1
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City | HYPOLUXO
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State | FL
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Zip | 33462-5487
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Country | US
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Telephone | 561-585-7106
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Fax | 561-585-4982
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Provider Business Mailing Address
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Address Line | 105 HALF MOON CIR #A-1
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City | HYPOLUXO
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State | FL
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Zip | 33462-5487
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Country | US
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Telephone | 561-585-7106
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Fax | 561-585-4982
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. VICKI JO CARRIER
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Credential | ARNP-BC
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Telephone | 561-585-7106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP1888442
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License Number State | FL
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