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1225120496
KENNETH NICOLLERAT
DURHAM, NC
NPI
1225120496
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: NC 033857)
Enumeration Date
2006-09-28
Last Update Date
2007-07-08
Business Address
-- KENNETH NICOLLERAT CRNA
3643 N ROXBORO ST
DURHAM, NC 27704-2702
Phone number: 919-470-6186
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Mailing Address
-- KENNETH NICOLLERAT CRNA
PO BOX 15609
DURHAM, NC 27704-0609
Phone number: 919-384-0200
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