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General NPI Number Information
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NPI Number | 1295734341
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Entity Type | Individual
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Provider Name | CHARLES M. FLINKO CRNA
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Gender | Male
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 05/08/2017
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Provider Practice Location Address
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Address Line | 2301 INDIAN WELLS RD
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City | ALAMOGORDO
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State | NM
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Zip | 88310-4611
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Country | US
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Telephone | 573-686-5550
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Fax |
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Provider Business Mailing Address
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Address Line | 209 S MAIN ST
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City | POPLAR BLUFF
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State | MO
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Zip | 63901-5831
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Country | US
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Telephone | 573-686-5550
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R0076448
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License Number State | OK
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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 | R12697
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License Number State | NM
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