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Individual
MRS. MARY E EIDENT
Active
Individual
MRS. MARY E EIDENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209021969
IL
363LF0000X
Family Nurse Practitioner
Primary
209.021969
IL
363LF0000X
Family Nurse Practitioner
APN.0997514-NP
CO
Other
Enumeration date
09/11/2020
Last updated
07/18/2022
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