Individual
ANN HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
11065 LITTLE PATUXENT PKWY, COLUMBIA, MD 21044-2998
(410) 328-3037
(410) 328-3040
Mailing address
PO BOX 64620, BALTIMORE, MD 21264-4620
(410) 328-3037
(410) 328-3040
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R128848
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R128848
MD BOARD OF NURSING LICEN
MD
Enumeration date
02/28/2006
Last updated
10/23/2007
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