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General NPI Number Information
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NPI Number | 1316986508
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Entity Type | Individual
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Provider Name | VALERIE KIM NELSON-MASON MD
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Gender | Female
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 10/09/2014
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Provider Practice Location Address
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Address Line | 330 1ST CAPITOL DR SUITE 340
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City | SAINT CHARLES
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State | MO
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Zip | 63301-2835
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Country | US
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Telephone | 636-255-3003
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Fax | 636-925-0954
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Provider Business Mailing Address
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Address Line | 330 1ST CAPITOL DR SUITE 340
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City | SAINT CHARLES
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State | MO
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Zip | 63301-2835
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Country | US
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Telephone | 636-255-3003
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Fax | 636-925-0954
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 2005000368
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License Number State | MO
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