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General NPI Number Information
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NPI Number | 1205200516
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Entity Type | Individual
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Provider Name | BETH ANN DAVISON CNM
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Gender | Female
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Dates
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Enumeration Date | 11/24/2015
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1005 LYNN LN
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City | MISSOULA
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State | MT
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Zip | 59801-3361
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Country | US
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Telephone | 406-926-2762
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Fax |
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Provider Business Mailing Address
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Address Line | 213 PALAZZO CIR
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-4504
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Country | US
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Telephone | 406-493-4247
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN9470700
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | APRN9470700
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License Number State | FL
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