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General NPI Number Information
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NPI Number | 1588683213
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Entity Type | Individual
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Provider Name | BRONWYN KATHLEEN RADCLIFFE F.N.P.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 03/18/2020
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Provider Practice Location Address
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Address Line | 355 COUNTY ROAD 503
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City | BAYFIELD
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State | CO
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Zip | 81122-9305
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Country | US
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Telephone | 970-238-0438
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Fax |
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Provider Business Mailing Address
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Address Line | 355 COUNTY ROAD 503
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City | BAYFIELD
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State | CO
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Zip | 81122-9305
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Country | US
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Telephone | 970-238-0438
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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 | CNP-01758
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024164985
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 100066-C-NP
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License Number State | CO
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