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General NPI Number Information
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NPI Number | 1609217462
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Entity Type | Individual
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Provider Name | STEPHANIE LYNN FOLTZER PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/09/2013
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 770 KAPIOLANI BLVD STE 705
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City | HONOLULU
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State | HI
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Zip | 96813
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Country | US
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Telephone | 808-597-8799
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Fax |
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Provider Business Mailing Address
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Address Line | 475 ATKINSON DR APT 1006
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City | HONOLULU
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State | HI
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Zip | 96814-4715
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Country | US
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Telephone | 973-573-0442
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00308900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | AMD890
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License Number State | HI
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