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General NPI Number Information
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NPI Number | 1871585547
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Entity Type | Individual
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Provider Name | RAMONA M DOMEN CRNA
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Gender | Female
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | NAVAL HOSPITAL GUAM ANESTHESIA DEPT
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City | FPO
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State | AP
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Zip | 96538-0490
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Country | US
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Telephone | 671-344-9304
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Fax |
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Provider Business Mailing Address
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Address Line | 184 JUAN M CRUZ DR
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City | SANTA RITA
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State | GU
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Zip | 96915-1743
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Country | US
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Telephone | 671-344-9386
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 51740
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License Number State | IL
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