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General NPI Number Information
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NPI Number | 1518317544
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Entity Type | Individual
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Provider Name | MEGAN GRACE FORSBERG AGPCNP-BC, RN
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Gender | Female
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Dates
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Enumeration Date | 06/21/2016
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 1483 E COURT ST
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City | SEGUIN
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State | TX
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Zip | 78155-5165
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Country | US
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Telephone | 830-560-2813
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Fax | 830-560-2812
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Provider Business Mailing Address
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Address Line | 1483 E COURT ST
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City | SEGUIN
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State | TX
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Zip | 78155-5165
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Country | US
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Telephone | 830-560-2813
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Fax | 830-560-2812
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AP131192
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP131192
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License Number State | TX
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