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General NPI Number Information
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NPI Number | 1922910223
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Entity Type | Individual
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Provider Name | SUSANA ALELY GABRIEL HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 09/21/2026
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Last Update Date | 09/21/2026
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Provider Practice Location Address
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Address Line | 400 S MAINT ST
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City | ROCKY MOUNT
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State | VA
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Zip | 24151-6287
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Country | US
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Telephone | 540-393-0509
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Fax |
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Provider Business Mailing Address
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Address Line | 545 CIRCLE VIEW ST
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City | ROCKY MOUNT
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State | VA
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Zip | 24151-6287
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Country | US
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Telephone | 540-393-0509
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001331372
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License Number State | VA
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