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General NPI Number Information
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NPI Number | 1598191215
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Entity Type | Individual
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Provider Name | ROMY LEE HAFNER APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 09/26/2013
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Last Update Date | 05/05/2023
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Provider Practice Location Address
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Address Line | 10151 SE SUNNYSIDE RD STE 100
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City | CLACKAMAS
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State | OR
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Zip | 97015-5705
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Country | US
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Telephone | 36-590-8805
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Fax | 503-513-7425
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Provider Business Mailing Address
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Address Line | 10151 SE SUNNYSIDE RD STE 100
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City | CLACKAMAS
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State | OR
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Zip | 97015-5705
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Country | US
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Telephone | 36-590-8805
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 100763
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201902105NP-PP
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP60927292
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License Number State | WA
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