Individual
AMY HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14131 MIDWAY RD STE 260, ADDISON, TX 75001-3623
(662) 415-9042
Mailing address
14131 MIDWAY RD STE 260, ADDISON, TX 75001-3623
(662) 415-9042
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
799031
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
AP132177
TX
Other
Enumeration date
09/16/2016
Last updated
01/31/2019
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