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General NPI Number Information
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NPI Number | 1942176375
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Entity Type | Organization
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Legal Business Name | FIRST CHOICE ADVANCE MOBILE WOUND CARE
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Dates
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Enumeration Date | 10/13/2025
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 2833 EXCHANGE CT STE D
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-4047
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Country | US
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Telephone | 561-254-2352
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Fax |
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Provider Business Mailing Address
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Address Line | 5645 OPAL DR
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City | WESTLAKE
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State | FL
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Zip | 33470-7063
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Country | US
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Telephone | 561-254-2352
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | KETTELIE HENRY
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Credential | NP
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Telephone | 561-254-2352
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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 |
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License Number State |
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