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NPI Code Detail

MEDICARE: MS. FAITH DANIELLE HENDRIXSON APRN-PMHNP

MEDICARE: MS. FAITH DANIELLE HENDRIXSON APRN-PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner124589AR

General Provider Information

NPI Number : 1578338562
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. FAITH DANIELLE HENDRIXSON APRN-PMHNP
Provider Business Mailing Address
First Line : 2255 STURGIS RD
Second Line :
City : CONWAY
State : AR
Zip : 72034-8029
Country : US
Telephone Number : 501-205-0011
Fax Number :
Provider Business Practice Location Address
First Line : 2255 STURGIS RD
Second Line :
City : CONWAY
State : AR
Zip : 72034-8029
Country : US
Telephone Number : 501-205-0011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2023
Last Update Date : 11/26/2023

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