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General NPI Number Information
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NPI Number | 1699289165
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Entity Type | Organization
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Legal Business Name | MOMS CHOICE MOBILE HEALTHCARE
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Dates
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Enumeration Date | 11/20/2017
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Last Update Date | 09/10/2022
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Provider Practice Location Address
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Address Line | 1730 BIG BEND BLVD
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City | FAIRVIEW
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State | TX
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Zip | 75069-1222
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Country | US
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Telephone | 201-240-3650
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Fax | 972-805-9030
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Provider Business Mailing Address
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Address Line | 4261 E UNIVERSITY DR STE 30-177
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City | PROSPER
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State | TX
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Zip | 75078-9152
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Country | US
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Telephone | 201-240-3650
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Fax | 972-805-9030
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Authorized Official
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Title or Position | OWNER
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Name | MRS. STEPHANIE GUIGNARD
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Credential | CPNP
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Telephone | 201-240-3650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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