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Individual
JESSICA FARLEY BODE
Active
Individual
JESSICA FARLEY BODE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
696527
CA
363LF0000X
Family Nurse Practitioner
Primary
22067
CA
Other
Enumeration date
06/24/2013
Last updated
06/24/2013
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