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Individual

MARNIE HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
750 BROADWAY AVE E, MATTOON, IL 61938-4610
(217) 238-5735
Mailing address
750 BROADWAY AVE E, MATTOON, IL 61938-4610
(217) 238-5735

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041316532
IL

Other

Enumeration date
05/17/2022
Last updated
05/17/2022
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