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General NPI Number Information
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NPI Number | 1679244685
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Entity Type | Individual
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Provider Name | KYLIE B JONES FNP
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Gender | Female
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Dates
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Enumeration Date | 09/21/2021
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Last Update Date | 11/02/2021
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Provider Practice Location Address
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Address Line | 230 E MARYDALE AVE
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City | SOLDOTNA
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State | AK
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Zip | 99669-7648
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Country | US
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Telephone | 907-262-3119
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Fax | 907-262-9290
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Provider Business Mailing Address
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Address Line | PO BOX 2949
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City | SOLDOTNA
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State | AK
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Zip | 99669-2949
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Country | US
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Telephone | 907-395-4303
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Fax | 907-283-4003
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9029118-3102
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License Number State | UT
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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 | 182981
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License Number State | AK
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