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Individual
KELLI EARL
Active
Individual
KELLI EARL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
332674
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
332674
LPN LICENSED
NY
Enumeration date
02/11/2019
Last updated
02/11/2019
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