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General NPI Number Information
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NPI Number | 1760777296
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Entity Type | Individual
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Provider Name | JENNIFER D HADEN D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/13/2011
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 1111 N HAYNES AVE
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City | CENTERVILLE
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State | IA
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Zip | 52544-1133
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Country | US
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Telephone | 641-552-1484
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Fax | 641-328-8729
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Provider Business Mailing Address
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Address Line | 1111 N HAYNES AVE
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City | CENTERVILLE
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State | IA
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Zip | 52544-1133
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Country | US
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Telephone | 641-552-1484
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Fax | 641-328-8729
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4333
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R-9253
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License Number State | IA
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