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General NPI Number Information
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NPI Number | 1669716239
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Entity Type | Individual
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Provider Name | MARCIE HOUSER ARNP
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Gender | Female
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Dates
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Enumeration Date | 11/20/2012
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 400 HEALTH PARK BLVD
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-5784
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Country | US
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Telephone | 904-819-5155
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 UNIVERSITY BLVD S STE 221
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4392
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Country | US
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Telephone | 904-423-0010
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Fax | 904-423-0012
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | SP012653
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License Number State | PA
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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 | ARNP9396574
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License Number State | FL
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