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General NPI Number Information
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NPI Number | 1316730617
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Entity Type | Individual
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Provider Name | MACKENZIE LYNN SAFFOLD CRNA
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Gender | Female
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 08/12/2026
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Provider Practice Location Address
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Address Line | 10965 CHERRY LAUREL DR
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City | FORT MYERS
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State | FL
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Zip | 33912-9156
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Country | US
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Telephone | 586-872-6455
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Fax |
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Provider Business Mailing Address
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Address Line | 10965 CHERRY LAUREL DR
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City | FORT MYERS
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State | FL
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Zip | 33912-9156
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Country | US
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Telephone | 586-872-6455
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9468192
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License Number State | FL
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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 | 8303
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License Number State | NC
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