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General NPI Number Information
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NPI Number | 1174447775
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Entity Type | Individual
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Provider Name | MELODI JO ALBENZE
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Gender | Female
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 621 S MAIN ST
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City | DU BOIS
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State | PA
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Zip | 15801-1413
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Country | US
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Telephone | 814-371-0600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 123
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City | SAINT PETERSBURG
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State | PA
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Zip | 16054-0123
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Country | US
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Telephone | 724-967-1023
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN683349
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | SP035383
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License Number State | PA
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