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General NPI Number Information
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NPI Number | 1922402718
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Entity Type | Organization
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Legal Business Name | ALLINA HEALTH SYSTEM
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Dates
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Enumeration Date | 10/22/2014
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | 701 DELLWOOD ST S
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City | CAMBRIDGE
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State | MN
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Zip | 55008-1920
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Country | US
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Telephone | 763-689-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 14700 28TH AVE N SUITE 20
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City | PLYMOUTH
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State | MN
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Zip | 55447-4835
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Country | US
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Telephone | 763-559-3791
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Fax |
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Authorized Official
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Title or Position | COO
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Name | DOMINICA TALLARICO
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Credential |
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Telephone | 612-222-2222
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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 |
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License Number State |
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