| NPI | 1932648318 |
|---|---|
| Former Name | JENNIFER JEAN HENDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015372) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209.015372) |
| 363LX0106X Nurse Practitioner, Occupational Health (Licence: IL 209015372) | |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2022-01-26 |