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General NPI Number Information
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NPI Number | 1396461182
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Entity Type | Individual
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Provider Name | TONI ANN RYAN AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/13/2022
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | 198 TYLER WAY
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City | BRISTOL
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State | CT
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Zip | 06010-9461
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Country | US
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Telephone | 860-890-6759
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Fax |
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Provider Business Mailing Address
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Address Line | 198 TYLER WAY
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City | BRISTOL
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State | CT
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Zip | 06010-9461
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Country | US
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Telephone | 860-890-6759
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 10880
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License Number State | CT
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