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General NPI Number Information
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NPI Number | 1194348714
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Entity Type | Individual
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Provider Name | CASSIDY NICOLE POWELL
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Gender | Female
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Dates
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Enumeration Date | 05/19/2020
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Last Update Date | 09/17/2023
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Provider Practice Location Address
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Address Line | 6045 N MAIN ST APT 349
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City | DAYTON
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State | OH
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Zip | 45415-3194
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Country | US
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Telephone | 937-564-8912
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Fax |
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Provider Business Mailing Address
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Address Line | 2351 CEDAR HILL RD NW
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City | CANAL WINCHESTER
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State | OH
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Zip | 43110-9509
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Country | US
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Telephone | 937-564-8912
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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 | 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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