Individual
MISS ADENA URSULA HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
129 4TH AVE E, JEROME, ID 83338-1901
(208) 420-6231
Mailing address
129 4TH AVE E, JEROME, ID 83338-1901
(208) 420-6231
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
09/28/2012
Last updated
09/28/2012
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