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General NPI Number Information
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NPI Number | 1235991605
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Entity Type | Individual
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Provider Name | ANN NEVILL PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/30/2024
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Last Update Date | 07/05/2024
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Provider Practice Location Address
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Address Line | 206 2ND ST E
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City | BRADENTON
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State | FL
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Zip | 34208-1000
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Country | US
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Telephone | 941-423-1067
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Fax | 855-253-4836
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Provider Business Mailing Address
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Address Line | PO BOX 25487
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City | SARASOTA
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State | FL
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Zip | 34277-2487
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Country | US
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Telephone | 941-202-5342
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Fax | 877-807-0253
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9118828
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License Number State | FL
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