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General NPI Number Information
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NPI Number | 1508765223
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Entity Type | Individual
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Provider Name | RILEY RAE GOLDSCHMIDT
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Gender | Female
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 424 W STATE HIGHWAY 5
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City | WACONIA
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State | MN
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Zip | 55387-1795
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Country | US
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Telephone | 952-442-4461
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Fax |
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Provider Business Mailing Address
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Address Line | 9114 WOODLAND DR
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City | SAINT BONIFACIUS
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State | MN
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Zip | 55375-4515
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Country | US
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Telephone | 320-262-0799
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 15002
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License Number State | MN
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