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General NPI Number Information
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NPI Number | 1275266561
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Entity Type | Individual
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Provider Name | ANNE ST JOHN NP
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Gender | Female
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Dates
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Enumeration Date | 07/05/2022
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 100A DRAKES LANDING ROAD SUITE 140
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City | GREENBRAE
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State | CA
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Zip | 94904
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Country | US
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Telephone | 415-925-7092
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Fax |
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Provider Business Mailing Address
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Address Line | 19 PIXLEY AVE APT 3
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City | CORTE MADERA
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State | CA
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Zip | 94925-1440
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Country | US
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Telephone | 415-225-9005
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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 | 11775
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License Number State | CA
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