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NPI 1215142393

NPI 1215142393 : VICKI S ARBUCKLE APRN : BLACKSBURG, VA

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General NPI Number Information
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    NPI Number           |    1215142393
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    Entity Type          |    Individual 
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    Provider Name        |    VICKI S ARBUCKLE APRN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/11/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    MCCOMAS HALL WASHINGTON STREET (0108)
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    City                 |    BLACKSBURG
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    State                |    VA
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    Zip                  |    24061-0001
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    Country              |    US
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    Telephone            |    540-231-9840
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    Fax                  |    540-231-2104
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Provider Business Mailing Address
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    Address Line         |    1501 CARLSON DR 
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    City                 |    BLACKSBURG
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    State                |    VA
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    Zip                  |    24060-5550
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    Country              |    US
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    Telephone            |    540-230-0325
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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       |    0024164807
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    License Number State |    VA
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