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Individual
LARRY VERNON ELJ
Active
Individual
LARRY VERNON ELJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7856
MN
Other
Enumeration date
09/25/2020
Last updated
11/23/2020
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