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General NPI Number Information
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NPI Number | 1215533021
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Entity Type | Individual
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Provider Name | SANDRA KAY HEISLER
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Gender | Female
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Dates
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Enumeration Date | 12/07/2020
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Last Update Date | 06/06/2022
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Provider Practice Location Address
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Address Line | 1260 GOLFVIEW AVE
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City | BARTOW
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State | FL
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Zip | 33830-6738
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Country | US
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Telephone | 863-519-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 4545 MOUNT VIEW DR
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City | LAKELAND
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State | FL
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Zip | 33813-1757
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Country | US
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Telephone | 863-430-7805
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11006147
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License Number State | FL
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