| NPI | 1104224336 |
|---|---|
| Other Name | TRICIA GENE HENDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 3521) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R177443-2) |
| Enumeration Date | 2014-12-22 |
| Last Update Date | 2016-03-24 |