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General NPI Number Information
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NPI Number | 1336741131
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Entity Type | Individual
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Provider Name | KATRINA MARIE FIELDHOUSE
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Gender | Female
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 7844 STONE RD
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City | MEDINA
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State | OH
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Zip | 44256-8999
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Country | US
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Telephone | 330-722-6650
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Fax |
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Provider Business Mailing Address
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Address Line | 4090 SKYVIEW DR APT 177
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City | BRUNSWICK
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State | OH
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Zip | 44212-1254
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Country | US
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Telephone | 330-410-6718
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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