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General NPI Number Information
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NPI Number | 1518349752
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Entity Type | Individual
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Provider Name | JOHN M PISTNER APRN, CRNA
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Gender | Male
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 25 N WINFIELD RD
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City | WINFIELD
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State | IL
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Zip | 60190-1379
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Country | US
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Telephone | 630-933-6675
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Fax | 630-933-2614
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Provider Business Mailing Address
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Address Line | 100 KIMEL FOREST DR
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City | WINSTON SALEM
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State | NC
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Zip | 27103-6074
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Country | US
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Telephone | 336-716-3245
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Fax | 336-716-0567
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN3074082
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 7943
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN3074082
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 209029410
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License Number State | IL
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