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General NPI Number Information
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NPI Number | 1902147481
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Entity Type | Individual
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Provider Name | MS. MAURA HACKETT
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Gender | Female
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Dates
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Enumeration Date | 03/08/2013
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Last Update Date | 03/08/2013
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Provider Practice Location Address
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Address Line | 1201 HOSPITAL DR
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-8428
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Country | US
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Telephone | 540-368-3800
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Fax | 540-368-3810
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Provider Business Mailing Address
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Address Line | 1201 HOSPITAL DR
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-8428
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Country | US
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Telephone | 540-368-3800
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Fax | 540-368-3810
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202007106
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 20 035777
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 14133
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License Number State | MD
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