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General NPI Number Information
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NPI Number | 1265703151
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Entity Type | Individual
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Provider Name | AMANDA L NELSON CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/24/2012
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 4400 NEW YORK AVE
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City | ARLINGTON
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State | TX
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Zip | 76018-4817
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Country | US
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Telephone | 817-852-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 1613 HARRISON PKWY SUITE 200
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City | SUNRISE
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State | FL
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Zip | 33323-2896
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Country | US
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Telephone | 954-838-2371
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Fax | 954-851-1746
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 747301
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 4704373720
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License Number State | MI
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