Individual
GRACE M HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
6940 MICHIGAN RD, INDIANAPOLIS, IN 46268-2800
(812) 325-3264
Mailing address
5843 LONG LAKE LN, INDIANAPOLIS, IN 46235-6127
(812) 325-3264
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
28223347A
IN
363L00000X
Nurse Practitioner
Primary
71012237A
IN
Other
Enumeration date
02/02/2022
Last updated
10/05/2022
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