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Individual
BILLY MANUEL
Active
Individual
BILLY MANUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
684280
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402391
NY
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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