Individual
MRS. KELLI HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
510 LINCOLN DR, HERRIN, IL 62948-6334
(618) 997-3100
Mailing address
1705 REDBUD LN, MARION, IL 62959-1536
(618) 926-2263
Taxonomy
Speciality
Code
Description
License number
State
163WX0800X
Orthopedic Registered Nurse
Primary
—
IL
Other
Enumeration date
04/14/2008
Last updated
04/14/2008
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