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General NPI Number Information
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NPI Number | 1780914846
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Entity Type | Individual
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Provider Name | AMELIA RUTH WIEAND R.N.
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Gender | Female
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 01/12/2010
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Provider Practice Location Address
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Address Line | 1501 RIVERSIDE DR SUITE 120
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City | CHATTANOOGA
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State | TN
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Zip | 37406-4309
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Country | US
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Telephone | 423-634-3110
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Fax | 423-634-5848
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Provider Business Mailing Address
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Address Line | 4040 MOUNTAIN CREEK RD APT # 2301
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City | CHATTANOOGA
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State | TN
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Zip | 37415-6034
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Country | US
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Telephone | 423-475-5696
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN0000159171
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License Number State | TN
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