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General NPI Number Information
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NPI Number | 1063279909
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Entity Type | Individual
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Provider Name | RACHEL MICHELLE MOCK
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Gender | Female
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Dates
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Enumeration Date | 03/05/2024
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 700 NE 13TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5004
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Country | US
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Telephone | 55-499-6904
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Fax |
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Provider Business Mailing Address
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Address Line | 3808 WOODSHADOW RD
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City | EDMOND
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State | OK
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Zip | 73003-3046
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Country | US
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Telephone | 405-401-2161
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | R0128713
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 364SA2100X
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Taxonomy Name | Acute Care Clinical Nurse Specialist
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License Number | 219745
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License Number State | OK
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