Individual
MRS. ANTOINETTE M HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6250 W WYANDOTTE RD, MAUMEE, OH 43537-1336
(567) 277-2156
Mailing address
6250 W WYANDOTTE RD, MAUMEE, OH 43537-1336
(567) 277-2156
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
532712
OH
164W00000X
Licensed Practical Nurse
142981
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142981
LICENSED PRACTICAL NURSE
OH
Enumeration date
03/21/2013
Last updated
08/07/2024
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