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General NPI Number Information
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NPI Number | 1558248666
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Entity Type | Individual
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Provider Name | PENNY SUE DOANE
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Gender | Female
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 307 W CEDAR AVE
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City | GLADWIN
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State | MI
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Zip | 48624-2065
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Country | US
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Telephone | 989-709-5288
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Fax |
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Provider Business Mailing Address
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Address Line | 362 S SHEARER RD
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City | GLADWIN
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State | MI
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Zip | 48624-7317
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Country | US
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Telephone | 989-709-6107
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 5303039259
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License Number State | MI
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