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General NPI Number Information
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NPI Number | 1497707145
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Entity Type | Individual
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Provider Name | VICTORIA ANN JARRETT PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 2011 HARRISON AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4545
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Country | US
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Telephone | 850-691-4188
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Fax | 833-687-1541
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Provider Business Mailing Address
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Address Line | 268 LILLY BELL LN
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City | FREEPORT
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State | FL
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Zip | 32439-7623
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 006217
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9107686
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License Number State | FL
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