Individual
MS. GRACE ALICIA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1007 N CASS ST, APT. #362, MILWAUKEE, WI 53202-3374
(815) 505-4209
Mailing address
1007 N CASS ST, APT. #362, MILWAUKEE, WI 53202-3374
(815) 505-4209
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
164595-030
WI
Other
Enumeration date
01/12/2010
Last updated
01/12/2010
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