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General NPI Number Information
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NPI Number | 1356156723
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Entity Type | Individual
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Provider Name | JESSICA KEIL CARON RNFA BSN
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Gender | Female
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 24451 HEALTH CENTER DR
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-3689
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Country | US
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Telephone | 949-837-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 420 S WATER ST
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City | MARINE CITY
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State | MI
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Zip | 48039-1690
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Country | US
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Telephone |
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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 | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 95183533
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License Number State | CA
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