Individual
KENNETH HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, NNP-BC
Contact information
Practice address
2635 N 7TH ST, GRAND JUNCTION, CO 81501-8209
(970) 298-2279
Mailing address
2635 N 7TH ST, GRAND JUNCTION, CO 81501-8209
(970) 298-2279
(970) 298-2222
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
APN.0994788-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14476351
—
CO
Enumeration date
07/17/2019
Last updated
07/17/2019
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