Individual
PLEAS V. HENDERSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
500 N NAPPANEE ST, STE 11-B, ELKHART, IN 46514-1503
(574) 522-9922
Mailing address
PO BOX 3055, INDIANAPOLIS, IN 46206-3055
(574) 522-9922
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28088177
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000970
—
IN
Enumeration date
06/05/2006
Last updated
11/18/2011
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