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General NPI Number Information
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NPI Number | 1073286878
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Entity Type | Individual
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Provider Name | RACHEL MIGUEL
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Gender | Female
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Dates
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Enumeration Date | 07/28/2021
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Last Update Date | 07/28/2021
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Provider Practice Location Address
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Address Line | 601 E DUPONT RD
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City | FORT WAYNE
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State | IN
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Zip | 46825-2055
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Country | US
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Telephone | 260-637-6115
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Fax |
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Provider Business Mailing Address
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Address Line | 15386 CANYON BAY RUN
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City | FORT WAYNE
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State | IN
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Zip | 46845-8657
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Country | US
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Telephone |
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 26029356A
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License Number State | IN
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