Individual
ANGELA HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1448 E 10TH ST, ROLLA, MO 65401-3648
(660) 207-7273
Mailing address
1448 E 10TH ST, ROLLA, MO 65401-3648
(660) 207-7273
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2006020329
MO
Other
Enumeration date
04/12/2017
Last updated
04/12/2017
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