Individual
ANITA HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7061 GRAND MONTECITO PKWY, LAS VEGAS, NV 89149-0287
(702) 750-3900
(702) 750-3916
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 242-7308
(702) 240-8790
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10115
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2018546
—
NV
05
—
3102646
—
NV
01
—
P00054853
RAILROAD MEDICARE
NV
Enumeration date
02/03/2006
Last updated
02/20/2014
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