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General NPI Number Information
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NPI Number | 1922866573
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Entity Type | Individual
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Provider Name | EMILY VENCIO HARDIN
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Gender | Female
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Dates
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Enumeration Date | 03/08/2024
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 2620 CREIGHTON RD STE 701
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City | PENSACOLA
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State | FL
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Zip | 32504-9317
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Country | US
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Telephone | 850-542-7502
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Fax |
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Provider Business Mailing Address
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Address Line | 5784 AVONDALE RD
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City | PENSACOLA
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State | FL
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Zip | 32526-2004
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Country | US
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Telephone | 850-384-0288
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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 | 224900000X
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Taxonomy Name | Mastectomy Fitter
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License Number |
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License Number State |
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