Individual
JESSICA HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-9980
(859) 301-4963
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 301-9980
(859) 301-4963
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4034651
KY
363LG0600X
Gerontology Nurse Practitioner
4034651
KY
Other
Enumeration date
01/29/2025
Last updated
04/29/2025
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