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Individual
THEODORA DESRONVIL
Active
Individual
THEODORA DESRONVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
303827
NC
363LF0000X
Family Nurse Practitioner
Primary
5010560
NC
Other
Enumeration date
04/24/2018
Last updated
06/10/2020
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