NPI | 1497868558 |
---|---|
Former Name | JENNIFER E HENDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 343199) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 516056-1) |
Enumeration Date | 2006-08-15 |
Last Update Date | 2018-06-27 |