Individual
MS. NICOLE BASHEE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
25045 GLENBROOKE DR, SOUTHFIELD, MI 48033-2513
(248) 632-0488
Mailing address
25045 GLENBROOKE DR, SOUTHFIELD, MI 48033-2513
(248) 632-0488
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703112391
MI
Other
Enumeration date
08/31/2023
Last updated
08/31/2023
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