Most Relevant Information
Provider Data
| NPI Number: | 1003198433 |
| Provider Name: | HEIDI B HENDERSON RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 2008023037 |
Most Important Dates
| Enumeration Date: | 09/12/2011 |
| Last Updated: | 09/12/2011 |
Provider Practice Location
1101 JAMISON ST
KIRKSVILLE
MO
635013943
Practice Location Phone/Fax
| Phone: | 6606651962 |
| Fax: | 6606270642 |
Provider Mailing Location
900 E LAHARPE ST
KIRKSVILLE
MO
635014520
Provider Mailing Phone/Fax
| Phone: | 6606651962 |
| Fax: | 6606653989 |