Individual
KIMBERLY E HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
520 NW 5TH ST, BRAINERD, MN 56401-2902
(507) 884-4856
Mailing address
520 NW 5TH ST, BRAINERD, MN 56401-2902
(218) 829-3235
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
996
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
313637000
—
MN
Enumeration date
02/15/2006
Last updated
01/10/2023
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