Individual
TONI SUZANNE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
5201 HARRY HINES BLVD, MEDICAL STAFF SERVICES, DALLAS, TX 75235-7708
(214) 590-8006
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
590165
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193271701
—
TX
01
—
8Y3726
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/06/2008
Last updated
09/02/2010
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