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Individual
MARK ELIJAH FANKHAUSER
Active
Individual
MARK ELIJAH FANKHAUSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
934497
TX
363L00000X
Nurse Practitioner
Primary
1110869
TX
Other
Enumeration date
01/30/2023
Last updated
02/17/2023
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