Individual
LISA YVETTE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
601 E BROADWAY ST, CUSHING, OK 74023-3432
(316) 308-5768
Mailing address
601 E BROADWAY ST, CUSHING, OK 74023-3432
(316) 308-5768
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
118316
OK
363LA2200X
Adult Health Nurse Practitioner
118316
OK
363LA2200X
Adult Health Nurse Practitioner
53-77543-021
KS
363LG0600X
Gerontology Nurse Practitioner
53-77543-021
KS
Other
Enumeration date
08/28/2017
Last updated
09/30/2025
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