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NPI 1811702467

NPI 1811702467 : JON AARON CRNP : JASPER, AL

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General NPI Number Information
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    NPI Number           |    1811702467
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    Entity Type          |    Individual 
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    Provider Name        |    JON AARON CRNP
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/11/2025
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    Last Update Date     |    02/14/2025
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Provider Practice Location Address
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    Address Line         |    3500 HIGHWAY 78 E STE A 
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    City                 |    JASPER
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    State                |    AL
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    Zip                  |    35501-8908
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    Country              |    US
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    Telephone            |    205-387-0333
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    Fax                  |    256-534-2605
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Provider Business Mailing Address
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    Address Line         |    PO BOX 18428 
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    City                 |    HUNTSVILLE
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    State                |    AL
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    Zip                  |    35804-8428
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    Country              |    US
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    Telephone            |    256-705-4224
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    Fax                  |    256-705-4135
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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        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    1-145644
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    License Number State |    AL
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