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NPI 1417808890

NPI 1417808890 : JANE ELIZABETH PFEUFER RD : BRUNSWICK, ME

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General NPI Number Information
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    NPI Number           |    1417808890
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    Entity Type          |    Individual 
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    Provider Name        |    JANE ELIZABETH PFEUFER RD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/03/2026
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    Last Update Date     |    02/03/2026
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Provider Practice Location Address
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    Address Line         |    74 UNION ST APT 3 
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    City                 |    BRUNSWICK
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    State                |    ME
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    Zip                  |    04011-2432
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    Country              |    US
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    Telephone            |    404-775-6149
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    74 UNION ST APT 3 
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    City                 |    BRUNSWICK
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    State                |    ME
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    Zip                  |    04011-2432
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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        |    133V00000X
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    Taxonomy Name        |    Registered Dietitian
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    License Number       |    D12203
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    License Number State |    ME
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