Individual
MARY KATHY HENDERSHOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
14 TRAFALGAR SQ, TRAFALGAR, IN 46181-9515
(317) 412-9190
(317) 878-2302
Mailing address
14 TRAFALGAR SQ, TRAFALGAR, IN 46181-9515
(317) 412-9190
(317) 878-2302
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71000119A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201028640
—
IN
Enumeration date
12/19/2006
Last updated
10/07/2013
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