Individual
MICHELLE LEE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
406 N WILLOW ST, HARRISON, AR 72601-3517
(870) 741-3252
(870) 741-3962
Mailing address
406 N WILLOW ST, HARRISON, AR 72601-3517
(870) 741-3252
(870) 741-3962
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A03547 APN
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4A202F478
MEDICARE PTAN
AR
Enumeration date
05/16/2011
Last updated
03/07/2018
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