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General NPI Number Information
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NPI Number | 1972088052
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Entity Type | Individual
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Provider Name | USHA VADAKKAN AGACNP
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Gender | Female
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Dates
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Enumeration Date | 09/25/2018
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | EMORY UNIVERSITY HOSPITAL 1364 CLIFTON ROAD NE
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City | ATLANTA
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State | GA
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Zip | 30322-2059
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Country | US
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Telephone | 404-778-4889
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Fax | 404-778-0826
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Provider Business Mailing Address
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Address Line | 2580 BENT CREEK DR
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City | CUMMING
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State | GA
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Zip | 30041-6366
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Country | US
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Telephone | 845-717-8340
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN200107
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | RN200107
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License Number State | GA
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