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Individual
NICOLE SUZETTE SOPER
Active
Individual
NICOLE SUZETTE SOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041330758
IL
363LF0000X
Family Nurse Practitioner
Primary
209014230
IL
Other
Enumeration date
05/10/2016
Last updated
11/25/2019
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