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General NPI Number Information
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NPI Number | 1467035634
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Entity Type | Individual
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Provider Name | LILIAM KATHERINE CARDENAS OLARTE PA
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Gender | Female
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Dates
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Enumeration Date | 05/04/2021
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 3590 W 9000 S STE 240
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City | WEST JORDAN
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State | UT
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Zip | 84088-8864
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Country | US
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Telephone | 801-508-3140
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Fax | 801-208-6374
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Provider Business Mailing Address
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Address Line | 6802 W VALLEY MAPLE DR
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City | WEST JORDAN
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State | UT
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Zip | 84081-3378
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Country | US
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Telephone | 714-654-7555
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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 | 13012366-1206
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 13012366-1206
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License Number State | UT
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