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General NPI Number Information
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NPI Number | 1326209495
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Entity Type | Individual
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Provider Name | NANCY L BOCCHINO CRNP
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Gender | Female
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Dates
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Enumeration Date | 06/21/2008
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 4508 CHESTNUT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19139-3608
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Country | US
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Telephone | 215-746-6894
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Fax | 214-746-7838
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Provider Business Mailing Address
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Address Line | 4508 CHESTNUT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19139-3608
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Country | US
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Telephone | 267-787-8300
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Fax | 267-787-8140
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | SPOO1895H
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP001895H
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | SP001895H
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License Number State | PA
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