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Individual
JARED NIX
Active
Individual
JARED NIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2250
SC
363AS0400X
Surgical Physician Assistant
TC120
KY
Other
Enumeration date
07/13/2012
Last updated
12/16/2014
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