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NPI 1659093938

NPI 1659093938 : BRITTNEY BOLIN CFNC, CNC, WLS, BCS : KING GEORGE, VA

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General NPI Number Information
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    NPI Number           |    1659093938
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    Entity Type          |    Individual 
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    Provider Name        |    BRITTNEY BOLIN CFNC, CNC, WLS, BCS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/14/2022
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    Last Update Date     |    09/14/2022
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Provider Practice Location Address
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    Address Line         |    7995 FULMONT DR 
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    City                 |    KING GEORGE
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    State                |    VA
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    Zip                  |    22485-3796
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    Country              |    US
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    Telephone            |    804-456-6609
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7995 FULMONT DR 
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    City                 |    KING GEORGE
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    State                |    VA
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    Zip                  |    22485-3796
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    Country              |    US
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    Telephone            |    804-456-6609
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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        |    133NN1002X
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    Taxonomy Name        |    Nutrition Education Nutritionist
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    License Number       |    
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    License Number State |    VA
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Taxonomy #2
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    Taxonomy Code        |    171400000X
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    Taxonomy Name        |    Health & Wellness Coach
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    License Number       |    
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    License Number State |    VA
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Taxonomy #3
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    Taxonomy Code        |    133N00000X
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    Taxonomy Name        |    Nutritionist
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    License Number       |    1200527544
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    License Number State |    VA
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