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Individual
MAURICIO VALENCIA
Active
Individual
MAURICIO VALENCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
10933
WI
363LF0000X
Family Nurse Practitioner
Primary
209.017085
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100170179
—
WI
Enumeration date
01/10/2018
Last updated
12/16/2022
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