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General NPI Number Information
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NPI Number | 1366786618
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Entity Type | Individual
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Provider Name | ROSE N MAINA NP
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Gender | Female
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Dates
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Enumeration Date | 11/26/2012
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Last Update Date | 08/26/2014
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Provider Practice Location Address
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Address Line | 11797 SOUTH FWY STE 330
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City | BURLESON
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State | TX
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Zip | 76028-7026
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Country | US
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Telephone | 817-293-1900
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Fax | 817-293-4930
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Provider Business Mailing Address
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Address Line | 601 OMEGA DR SUITE 206
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City | ARLINGTON
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State | TX
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Zip | 76014-2075
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Country | US
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Telephone | 817-465-5881
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Fax | 817-465-6336
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 808274
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License Number State | TX
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