Individual
CATRINA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
30 WINDING PATH APT 7, MANORVILLE, NY 11949-2268
(631) 603-4078
Mailing address
47 ROSE LN, MEDFORD, NY 11763-1328
(631) 353-5075
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
784162-01
NY
164W00000X
Licensed Practical Nurse
318979
NY
Other
Enumeration date
01/06/2015
Last updated
03/13/2020
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