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General NPI Number Information
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NPI Number | 1083412993
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Entity Type | Individual
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Provider Name | JACKLYN ROSE WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 09/27/2026
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Provider Practice Location Address
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Address Line | 6200 W PARKER RD
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City | PLANO
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State | TX
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Zip | 75093-8185
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Country | US
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Telephone | 972-981-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 133 BIRDBROOK DR
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City | ANNA
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State | TX
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Zip | 75409-5193
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 109467
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1094607
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 163WN0800X
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Taxonomy Name | Neuroscience Registered Nurse
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License Number | 1094607
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License Number State | TX
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