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1194553826
TEQUILA ANDERSON
COLUMBIA, SC
NPI
1194553826
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP2300X Nurse Practitioner, Primary Care
(Licence: SC 29092)
Enumeration Date
2024-07-24
Last Update Date
2024-10-22
Business Address
TEQUILA ANDERSON NP
3710 LANDMARK DR STE 408
COLUMBIA, SC 29204-4034
Phone number: 803-227-5320
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Mailing Address
TEQUILA ANDERSON NP
PO BOX 530062
ATLANTA, GA 30353-0062
Phone number: 763-348-2075
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