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General NPI Number Information
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NPI Number | 1952306672
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Entity Type | Organization
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Legal Business Name | MOTHER FRANCES HOSPITAL JACKSONVILLE
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 2026 S JACKSON ST
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City | JACKSONVILLE
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State | TX
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Zip | 75766-5822
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Country | US
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Telephone | 903-541-4500
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Fax | 903-541-4679
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Provider Business Mailing Address
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Address Line | PO BOX 847522
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City | DALLAS
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State | TX
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Zip | 75284-7522
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Country | US
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Telephone | 903-541-4500
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Fax | 903-541-4679
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Authorized Official
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Title or Position | PROVIDER ENROLLMENT SPECIALIST
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Name | ANGELA HUFF
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Credential |
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Telephone | 903-606-6425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 007254
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License Number State | TX
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