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General NPI Number Information
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NPI Number | 1235789231
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Entity Type | Individual
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Provider Name | MAXWELL HOGUE
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Gender | Male
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Dates
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Enumeration Date | 09/12/2019
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 375 WAMPANOAG TRL
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City | RIVERSIDE
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State | RI
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Zip | 02915-2232
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Country | US
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Telephone | 401-649-4020
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Fax | 401-649-4021
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Provider Business Mailing Address
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Address Line | 619 BOSTON NECK RD
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-6235
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Country | US
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Telephone | 603-667-6765
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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 | RN2313022
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN02399
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License Number State | RI
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