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General NPI Number Information
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NPI Number | 1457866816
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Entity Type | Individual
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Provider Name | KERRIE SHAW BEGLEY PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/07/2017
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Last Update Date | 08/01/2019
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Provider Practice Location Address
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Address Line | 8331 N DAVIS HWY
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City | PENSACOLA
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State | FL
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Zip | 32514-6094
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Country | US
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Telephone | 850-505-4720
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Fax | 850-505-4726
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Provider Business Mailing Address
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Address Line | 10140 CENTURION PKWY N
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City | JACKSONVILLE
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State | FL
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Zip | 32256-0532
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9111071
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License Number State | FL
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