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Individual
TESA L IVEY
Active
Individual
TESA L IVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
A03357 ANP
AR
Other
Enumeration date
04/02/2010
Last updated
08/09/2010
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