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Individual

REX M. HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
810 E 23RD ST, SIOUX FALLS, SD 57105-2135
(605) 331-5890
(605) 336-3974
Mailing address
810 E 23RD ST, P.O. BOX 5116, SIOUX FALLS, SD 57105-2135
(605) 331-5890
(605) 336-3974

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CR000035
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5751020
SD
Enumeration date
08/31/2006
Last updated
11/16/2007
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