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General NPI Number Information
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NPI Number | 1861391179
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Entity Type | Individual
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Provider Name | MARILYN RUTH WITHERSPOON RN
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Gender | Female
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Dates
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Enumeration Date | 11/03/2026
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Last Update Date | 11/03/2026
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Provider Practice Location Address
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Address Line | 7600 FRANCE AVE S STE 4200
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City | EDINA
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State | MN
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Zip | 55435-6028
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Country | US
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Telephone | 952-428-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 CHICAGO AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55407-1321
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Country | US
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Telephone | 612-262-9000
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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 | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | R-1310508-2313587
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License Number State | MN
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