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General NPI Number Information
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NPI Number | 1730664723
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Entity Type | Individual
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Provider Name | KATRIN JOHANNA KAHL PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/26/2018
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 610 N CALIFORNIA ST
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City | MISSOULA
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State | MT
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Zip | 59802-3950
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Country | US
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Telephone | 406-721-1646
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Fax | 406-543-9890
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Provider Business Mailing Address
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Address Line | 610 N CALIFORNIA ST
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City | MISSOULA
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State | MT
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Zip | 59802-3950
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Country | US
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Telephone | 406-721-1646
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Fax | 406-543-9890
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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 | MED-PAC-LIC-137293
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License Number State | MT
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