Individual
WESLEY ANDREW HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8885 INDIANA-237, TELL CITY, IN 47586
(812) 547-7011
Mailing address
468 FONSO CIR, BOWLING GREEN, KY 42104-5582
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
90868
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100228600
—
KY
Enumeration date
11/09/2012
Last updated
06/02/2016
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