Individual
DR. MICAH HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-BC
Contact information
Practice address
1650 COCHRANE CIR, FORT CARSON, CO 80913-4613
(719) 524-2273
Mailing address
1650 COCHRANE CIR, FORT CARSON, CO 80913-4613
(719) 524-2273
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN0992015
CO
363LP2300X
Primary Care Nurse Practitioner
APN0992015
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45681
MEDICARE - GROUP
FL
01
—
APN0992015
LICENSE APN
CO
01
—
ARNP9195240
LICENSE
FL
01
—
HN217Z
MEDICARE - INDIVIDUAL
FL
Enumeration date
08/13/2013
Last updated
05/01/2025
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