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General NPI Number Information
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NPI Number | 1033697784
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Entity Type | Individual
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Provider Name | CHRISTIANE T HORMAN
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Gender | Female
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Dates
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Enumeration Date | 08/04/2018
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Last Update Date | 08/04/2018
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Provider Practice Location Address
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Address Line | 1919 CORK OAK LN
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City | MANTECA
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State | CA
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Zip | 95336-9129
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Country | US
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 4032 HUBBARD RD
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City | STOCKTON
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State | CA
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Zip | 95215-1854
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Country | US
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Telephone | 209-969-4633
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | VN240115
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License Number State | CA
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