Individual
JACQUELINE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
140 LA LUZ GATE RD, ALAMOGORDO, NM 88310-9253
(575) 495-5550
Mailing address
140 LA LUZ GATE RD, ALAMOGORDO, NM 88310-9253
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
75040
NM
Other
Enumeration date
03/10/2026
Last updated
03/10/2026
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