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General NPI Number Information
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NPI Number | 1518375120
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Entity Type | Individual
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Provider Name | LOIS CASSLE ARNP
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Gender | Female
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Dates
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Enumeration Date | 07/28/2014
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Last Update Date | 07/28/2014
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Provider Practice Location Address
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Address Line | 5189 NW WISK FERN CIR
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City | PORT ST LUCIE
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State | FL
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Zip | 34986-4385
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Country | US
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Telephone | 772-924-8632
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Fax |
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Provider Business Mailing Address
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Address Line | 5189 NW WISK FERN CIR
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City | PORT ST LUCIE
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State | FL
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Zip | 34986-4385
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP 9251042
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License Number State | FL
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