Individual
MYRA A HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1115 WOODLAND DR, ELIZABETHTOWN, KY 42701-2749
(270) 769-5963
(270) 769-9051
Mailing address
1115 WOODLAND DR, ELIZABETHTOWN, KY 42701-2749
(270) 769-5963
(270) 769-9051
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
02554
KY
207VE0102X
Reproductive Endocrinology Physician
Primary
02554
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64025547
—
KY
Enumeration date
09/06/2006
Last updated
03/02/2026
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