Individual
ANITRA LATASHA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N
Contact information
Practice address
11114 REVERE AVE, CLEVELAND, OH 44105
(216) 856-4147
Mailing address
11114 REVERE AVE, CLEVELAND, OH 44105
(216) 856-4147
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
344268
OH
Other
Enumeration date
02/19/2009
Last updated
02/19/2009
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