Individual
JANET HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
35 BROAD ST, KEYPORT, NJ 07735-1267
(732) 888-4149
(732) 264-0799
Mailing address
35 BROAD ST, KEYPORT, NJ 07735-1267
(732) 888-4155
(732) 264-0799
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NN11177600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0119385
—
NJ
Enumeration date
06/14/2006
Last updated
05/08/2018
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