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NPI 1497146781

NPI 1497146781 : BRIDGETT CREWS : DADE CITY, FL

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General NPI Number Information
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    NPI Number           |    1497146781
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    Entity Type          |    Individual 
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    Provider Name        |    BRIDGETT CREWS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/09/2015
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    Last Update Date     |    02/09/2015
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Provider Practice Location Address
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    Address Line         |    9315 HANDCART RD. 
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    City                 |    DADE CITY
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    State                |    FL
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    Zip                  |    33525
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    Country              |    US
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    Telephone            |    813-690-6120
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9315 HANDCART RD 
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    City                 |    DADE CITY
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    State                |    FL
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    Zip                  |    33525-8280
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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        |    171M00000X
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    Taxonomy Name        |    Case Manager/Care Coordinator
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    License Number       |    
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    License Number State |    
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