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NPI Code Detail

MEDICARE: STACY TWAIT RN

MEDICARE: STACY TWAIT RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse755977TX

General Provider Information

NPI Number : 1609303239
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY TWAIT RN
Provider Business Mailing Address
First Line : 1700 POSSUM TRL
Second Line :
City : HARKER HEIGHTS
State : TX
Zip : 76548-2110
Country : US
Telephone Number : 254-291-9718
Fax Number :
Provider Business Practice Location Address
First Line : 1020 BLUE BIRD DR
Second Line :
City : HARKER HEIGHTS
State : TX
Zip : 76548-1238
Country : US
Telephone Number : 254-291-9718
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2017
Last Update Date : 05/14/2017

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