Individual
AMBER L HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
65 RINGOLD LN, MORGANTOWN, WV 26508
(304) 612-4662
Mailing address
65 RINGOLD LN, MORGANTOWN, WV 26508-8871
(304) 612-4662
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
52671
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2602523000
—
WV
Enumeration date
08/23/2006
Last updated
05/16/2018
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