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General NPI Number Information
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NPI Number | 1821850926
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Entity Type | Individual
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Provider Name | NICHOLE RENEE HACKNEY LM, CPM
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Gender | Female
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Dates
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Enumeration Date | 01/25/2024
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 2474 AURELIA SCHOOL RD
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City | NOCONA
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State | TX
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Zip | 76255-6089
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Country | US
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Telephone | 940-531-8986
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Fax |
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Provider Business Mailing Address
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Address Line | 2474 AURELIA SCHOOL RD
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City | NOCONA
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State | TX
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Zip | 76255-6089
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Country | US
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Telephone | 940-531-8986
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | 99542
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License Number State | TX
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