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NPI 1790322030

NPI 1790322030 : KNIT TOGETHER HEALTHCARE : CLINTON, MS

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General NPI Number Information
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    NPI Number           |    1790322030
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    Entity Type          |    Organization 
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    Legal Business Name  |    KNIT TOGETHER HEALTHCARE 
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Dates
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    Enumeration Date     |    12/05/2019
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    Last Update Date     |    01/22/2020
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Provider Practice Location Address
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    Address Line         |    113 OAKHURST DR 
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    City                 |    CLINTON
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    State                |    MS
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    Zip                  |    39056-3121
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    Country              |    US
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    Telephone            |    601-896-3102
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    113 OAKHURST DR 
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    City                 |    CLINTON
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    State                |    MS
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    Zip                  |    39056-3121
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    Country              |    US
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    Telephone            |    601-896-3102
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    Fax                  |    
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Authorized Official
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    Title or Position    |    RN
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    Name                 |    MRS. ELISE ADES MILLIMAN 
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    Credential           |    RN
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    Telephone            |    601-896-3102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251J00000X
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    Taxonomy Name        |    Nursing Care Agency
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    License Number       |    
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    License Number State |    
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