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Individual
MS. MARY JETER
Active
Individual
MS. MARY JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
507959
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02521
TELE CARE CORPORATION
CA
Enumeration date
12/20/2017
Last updated
12/20/2017
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