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NPI 1689139602

NPI 1689139602 : HALLIE MCCARN : TERRE HAUTE, IN

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General NPI Number Information
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    NPI Number           |    1689139602
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    Entity Type          |    Individual 
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    Provider Name        |    HALLIE MCCARN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/04/2019
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    Last Update Date     |    01/18/2024
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Provider Practice Location Address
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    Address Line         |    524 S 21ST ST 
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    City                 |    TERRE HAUTE
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    State                |    IN
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    Zip                  |    47803-2532
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    Country              |    US
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    Telephone            |    336-596-6491
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    503 S MULLER PKWY APT 303 
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    City                 |    BLOOMINGTON
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    State                |    IN
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    Zip                  |    47403-1635
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    Country              |    US
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    Telephone            |    
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    36003749A
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    License Number State |    IN
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