Individual
COLLEEN HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
303 N 7TH ST, KENTLAND, IN 47951-1379
(219) 474-5464
Mailing address
303 N 7TH ST, KENTLAND, IN 47951-1379
(219) 474-5464
(219) 474-3603
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2015021650
IN
Other
Enumeration date
01/26/2016
Last updated
10/13/2020
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