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General NPI Number Information
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NPI Number | 1164922381
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Entity Type | Individual
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Provider Name | ROMELLA M OGBEBOR
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Gender | Female
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Dates
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Enumeration Date | 02/14/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 29751 N 121ST DR
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City | PEORIA
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State | AZ
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Zip | 85383-3498
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Country | US
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Telephone | 480-600-1770
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Fax |
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Provider Business Mailing Address
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Address Line | 19437 N NEW TRADITION RD
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City | SUN CITY WEST
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State | AZ
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Zip | 85376-5981
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Country | US
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Telephone | 800-674-3510
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Fax | 800-674-3510
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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