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Individual

ZILLA F HENRICKSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
5194 HIGHWAY 100 STE 106, LYLES, TN 37098-2822
(931) 670-1102
(931) 670-1065
Mailing address
127 CRESTVIEW PARK DR STE 209, DICKSON, TN 37055-2856
(615) 446-5121
(615) 446-1357

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP129005
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN19374
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00FM20
MEDICARE PTAN
TX
Enumeration date
10/14/2015
Last updated
08/19/2022
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