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General NPI Number Information
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NPI Number | 1487922381
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Entity Type | Individual
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Provider Name | ASHLEY ROSE MERRILL LDM, CPM
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Gender | Female
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Dates
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Enumeration Date | 12/06/2011
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Last Update Date | 03/12/2013
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Provider Practice Location Address
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Address Line | 235 E. MAIN ST.
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City | JACKSONVILLE
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State | OR
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Zip | 97530
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Country | US
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Telephone | 971-322-7398
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1394
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City | JACKSONVILLE
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State | OR
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Zip | 97530-1394
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Country | US
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Telephone | 971-322-7398
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | DEM-LD-10152621
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License Number State | OR
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