Individual
TESSA SUZANNE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12596 W BAYAUD AVE STE 100, LAKEWOOD, CO 80228-2035
(303) 649-3050
Mailing address
12596 W BAYAUD AVE STE 100, LAKEWOOD, CO 80228-2035
(303) 649-3050
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APN.0990650-NP
CO
363LF0000X
Family Nurse Practitioner
Primary
APN.0990650-NP
CO
363LG0600X
Gerontology Nurse Practitioner
APN.0990650-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
384572YQ3L
MEDICARE
CO
01
—
384572YQN9
MEDICARE
CO
01
—
384572YQPG
MEDICARE
CO
Enumeration date
06/21/2013
Last updated
08/04/2025
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