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General NPI Number Information
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NPI Number | 1811952047
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Entity Type | Organization
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Legal Business Name | WOMENS MEDICAL HEALTH CENTER INC
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1956 MESQUITE AVE SUITE 103
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5888
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Country | US
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Telephone | 928-505-5300
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Fax | 928-505-2333
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Provider Business Mailing Address
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Address Line | 1956 MESQUITE AVE SUITE 103
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5888
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Country | US
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Telephone | 928-505-5300
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Fax | 928-505-2333
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Authorized Official
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Title or Position | OWNER/NP
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Name | ELAINE RUTH HENSON
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Credential | ANP
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Telephone | 928-505-5300
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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 | AZNP54
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License Number State | AZ
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