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General NPI Number Information
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NPI Number | 1831095751
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Entity Type | Organization
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Legal Business Name | LE PUR BLANC
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Dates
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Enumeration Date | 10/16/2026
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Last Update Date | 10/16/2026
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Provider Practice Location Address
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Address Line | 109 MASON ST APT 2
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City | SALEM
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State | MA
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Zip | 01970-2285
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Country | US
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Telephone | 857-887-1596
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Fax | 617-415-2766
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Provider Business Mailing Address
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Address Line | 30 N GOULD ST
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City | SHERIDAN
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State | WY
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Zip | 82801-6317
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Country | US
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Telephone | 857-887-1596
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Fax | 617-415-2766
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Authorized Official
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Title or Position | OWNER/PMHNP
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Name | FRANCINE FORBES
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Credential |
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Telephone | 857-258-1542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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