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General NPI Number Information
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NPI Number | 1699365106
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Entity Type | Individual
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Provider Name | MIMI HENDERSON HILL PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/20/2021
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 901 SE PLAZA AVE STE 5
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City | BENTONVILLE
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State | AR
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Zip | 72712-5473
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Country | US
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Telephone | 479-273-3376
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Fax |
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Provider Business Mailing Address
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Address Line | 901 SE PLAZA AVE STE 5
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City | BENTONVILLE
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State | AR
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Zip | 72712-5473
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Country | US
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Telephone | 479-876-8550
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Fax | 479-208-4266
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA-976
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License Number State | AR
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