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Individual

MRS. KATHI LEE HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1513 N RANDALL AVE, ELK CITY, OK 73644
(580) 225-4466
(580) 225-2417
Mailing address
1513 N RANDALL AVE, ELK CITY, OK 73644-1407
(580) 225-4466
(580) 225-2417

Taxonomy

Speciality
Code
Description
License number
State
364SP0200X
Pediatric Clinical Nurse Specialist
Primary
20091470
OK

Other

Enumeration date
12/14/2009
Last updated
12/14/2009
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