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General NPI Number Information
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NPI Number | 1336347814
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Entity Type | Individual
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Provider Name | JO ANN WILSON RN
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Gender | Female
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Dates
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Enumeration Date | 07/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2173 CENTERVILLE PL # A
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4356
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Country | US
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Telephone | 850-385-0144
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 452198
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City | SUNRISE
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State | FL
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Zip | 33345-2198
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Country | US
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Telephone | 800-437-2672
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Fax | 954-851-1758
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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 | RN3187572
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License Number State | FL
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