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Individual

CHAD M HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
100 3RD AVE W STE 110, BRADENTON, FL 34205-8641
(941) 708-9555
(941) 708-5465
Mailing address
100 3RD AVE W STE 110, BRADENTON, FL 34205-8641
(941) 708-9555
(941) 708-5465

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71006007A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000985739
ANTHEM
IN
05
201339890
IN
01
4188885
AETNA
FL
01
JG667Z
MEDICARE
FL
01
RYIMI
BCBS FL
FL
Enumeration date
12/03/2015
Last updated
06/24/2024
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