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Individual
JAMIE LYNN HENDERSON
Active
Individual
JAMIE LYNN HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28215294A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300084195
—
IN
Enumeration date
10/05/2023
Last updated
01/08/2024
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