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Individual
NICOLE I BENNER
Active
Individual
NICOLE I BENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN001026
PA
Other
Enumeration date
04/21/2014
Last updated
04/21/2014
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