| NPI | 1073795688 |
|---|---|
| Former Name | NICOLE M HENDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ00148100) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA NPPA043263) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2021-06-01 |