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General NPI Number Information
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NPI Number | 1255909917
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Entity Type | Individual
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Provider Name | OLIVIA ANN WELTON FNP
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Gender | Female
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Dates
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Enumeration Date | 06/17/2021
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 2200 EDISON ST
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City | BRUSH
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State | CO
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Zip | 80723-1609
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Country | US
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Telephone | 641-691-1760
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Fax |
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Provider Business Mailing Address
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Address Line | 2904 W LINCOLN WAY
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City | MARSHALLTOWN
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State | IA
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Zip | 50158-6021
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Country | US
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Telephone | 641-691-1760
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | A163937
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License Number State | IA
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