Individual
TARA ANN HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, NP-C
Contact information
Practice address
1575 N SANTA FE AVE, EDMOND, OK 73003-3638
(405) 285-0660
Mailing address
5416 PIEDMONT RD N, PIEDMONT, OK 73078-9177
(405) 368-4506
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
123087
OK
Other
Enumeration date
09/10/2017
Last updated
09/10/2017
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