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General NPI Number Information
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NPI Number | 1033932793
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Entity Type | Individual
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Provider Name | VINCENT JOSEPH LAIRD PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 1013 MUMMA RD STE 303
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City | WORMLEYSBURG
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State | PA
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Zip | 17043-1144
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Country | US
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Telephone | 717-516-7278
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Fax |
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Provider Business Mailing Address
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Address Line | 918 MAY ST
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City | MCKEESPORT
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State | PA
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Zip | 15132-3329
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Country | US
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Telephone | 412-426-0011
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP030894
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License Number State | PA
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