Organization
BRANDY HENDERSON APRN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDY M HENDERSON APRN (OWNER)
(812) 786-6639
Entity
Organization
Contact information
Practice address
15150 CRONEWOOD LN, MEMPHIS, IN 47143-9417
(812) 786-6639
Mailing address
15150 CRONEWOOD LN, MEMPHIS, IN 47143-9417
(812) 786-6639
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000909082
ANTHEM
KY
05
—
7100321840
—
KY
Enumeration date
11/22/2014
Last updated
02/06/2015
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