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General NPI Number Information
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NPI Number | 1679113708
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Entity Type | Individual
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Provider Name | MICHELLE LOUISE BAY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 06/12/2024
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Provider Practice Location Address
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Address Line | 2401 W GRAND ST
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City | SPRINGFIELD
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State | MO
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Zip | 65802-4967
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Country | US
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Telephone | 417-864-4545
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 735378
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City | CHICAGO
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State | IL
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Zip | 60673-5378
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Country | US
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Telephone | 877-787-3430
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 2019002146
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License Number State | MO
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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 | 2019002146
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License Number State | MO
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