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General NPI Number Information
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NPI Number | 1225533284
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Entity Type | Individual
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Provider Name | VOLONDA SHEREDITH JACKSON
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Gender | Female
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 33702 WINDCREST ESTATES BLVD
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City | MAGNOLIA
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State | TX
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Zip | 77354-4860
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Country | US
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Telephone | 281-650-3525
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Fax |
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Provider Business Mailing Address
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Address Line | 1620 E RIVERSIDE DR APT 6038
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City | AUSTIN
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State | TX
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Zip | 78741-1037
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Country | US
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Telephone | 281-650-3525
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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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 | 66996
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License Number State | TX
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