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NPI 1225877400

NPI 1225877400 : DAWN WALTERS TATE RN : PENSACOLA, FL

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General NPI Number Information
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    NPI Number           |    1225877400
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    Entity Type          |    Individual 
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    Provider Name        |    DAWN WALTERS TATE RN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/20/2024
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    Last Update Date     |    05/20/2024
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Provider Practice Location Address
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    Address Line         |    915 E FAIRFIELD DR 
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    City                 |    PENSACOLA
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    State                |    FL
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    Zip                  |    32503-2816
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    Country              |    US
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    Telephone            |    850-444-3400
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    Fax                  |    850-595-0096
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Provider Business Mailing Address
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    Address Line         |    1011 E GONZALEZ ST 
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    City                 |    PENSACOLA
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    State                |    FL
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    Zip                  |    32503-6048
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    Country              |    US
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    Telephone            |    850-572-8289
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    Fax                  |    850-595-0096
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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        |    171400000X
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    Taxonomy Name        |    Health & Wellness Coach
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    License Number       |    
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    License Number State |    
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