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General NPI Number Information
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NPI Number | 1245796747
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Entity Type | Individual
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Provider Name | NICOLE CAITLYN WAUGH RN, ARNP
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Gender | Female
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Dates
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Enumeration Date | 02/20/2019
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 1313 11TH STREET PL SW
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City | PUYALLUP
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State | WA
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Zip | 98371-7316
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Country | US
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Telephone | 206-915-9766
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Fax |
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Provider Business Mailing Address
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Address Line | 1313 11TH STREET PL SW
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City | PUYALLUP
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State | WA
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Zip | 98371-7316
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Country | US
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Telephone | 206-915-9766
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN60860900
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License Number State | WA
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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 | AP.70077810
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License Number State | WA
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