Individual
SUSAN HENDERSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
830 W HIGH ST, SUITE 307, LIMA, OH 45801-3971
(419) 227-5298
(419) 227-5879
Mailing address
830 W HIGH ST, SUITE 307, LIMA, OH 45801-3971
(419) 227-5298
(419) 227-5879
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP05563
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2189199
—
OH
Enumeration date
09/13/2005
Last updated
07/08/2007
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