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General NPI Number Information
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NPI Number | 1568271922
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Entity Type | Organization
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Legal Business Name | WEATHERFORD WHOLEHEALTH
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 1880 SANTA FE DR STE 400
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City | WEATHERFORD
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State | TX
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Zip | 76086-6486
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Country | US
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Telephone | 817-757-7094
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Fax | 817-549-4769
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Provider Business Mailing Address
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Address Line | 1880 SANTE FE DRIVE SUITE 400
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City | WEATHERFORD
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State | TX
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Zip | 76086
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Country | US
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Telephone | 817-694-8396
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Fax | 817-549-4769
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | KRISTIN TOLLETT
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Credential | MSN, RN, FNP-C
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Telephone | 817-757-7094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | NULL
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