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General NPI Number Information
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NPI Number | 1598205247
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Entity Type | Individual
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Provider Name | WENDY MITCHELL
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Gender | Female
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Dates
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Enumeration Date | 02/28/2017
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 5508 PINETREE DR
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City | FORT PIERCE
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State | FL
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Zip | 34982-7452
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Country | US
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Telephone | 330-600-4156
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Fax |
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Provider Business Mailing Address
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Address Line | 10225 FULTON RD
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City | MARSHALLVILLE
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State | OH
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Zip | 44645-9761
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Country | US
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Telephone | 330-600-4156
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 122438
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License Number State | OH
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