Individual
LACEY HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2423 ROUTE 2, HERMON, ME 04401-0609
(207) 742-2839
Mailing address
2423 ROUTE 2, HERMON, ME 04401-0609
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN54403
ME
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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