Individual
LISA HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
5 PERRYRIDGE RD, GREENWICH, CT 06830-4608
(203) 863-3000
(203) 863-4520
Mailing address
5 PERRYRIDGE RD, GREENWICH, CT 06830-4608
(203) 863-3000
(203) 863-4520
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
003209
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003209
APRN
CT
01
—
075252
RN
CT
Enumeration date
11/05/2007
Last updated
11/05/2007
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