Individual
KELLY G. HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
11725 W 112TH ST, OVERLAND PARK, KS 66210-2761
(913) 469-5579
(913) 338-1311
Mailing address
11755 W 112TH ST, SUITE 203, OVERLAND PARK, KS 66210-2761
(913) 469-0503
(913) 338-1311
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-00672
KS
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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