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NPI 1306358957

NPI 1306358957 : MRS. KRISTY ANN CALL : IDAHO FALLS, ID

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General NPI Number Information
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    NPI Number           |    1306358957
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    Entity Type          |    Individual 
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    Provider Name        |    MRS. KRISTY ANN CALL
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/03/2017
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    Last Update Date     |    11/03/2017
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Provider Practice Location Address
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    Address Line         |    10982 N 37TH E 
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    City                 |    IDAHO FALLS
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    State                |    ID
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    Zip                  |    83401-6400
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    Country              |    US
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    Telephone            |    208-604-2912
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    10982 N 37TH E 
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    City                 |    IDAHO FALLS
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    State                |    ID
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    Zip                  |    83401-6400
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    Country              |    US
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    Telephone            |    208-604-2912
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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        |    253Z00000X
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    Taxonomy Name        |    In Home Supportive Care Agency
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    License Number       |    82-2713205
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    License Number State |    ID
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