Henderson, Jacqueline

Henderson, Jacqueline is an individual health care provider with primary practice located at 4219 Laclede Ave Suite B, Saint Louis MO 63108-2814. She recently has only one registered license in Nursing Service Providers / Psychiatric/Mental Health, Adult, which is considered as her primary health care specialty. Henderson, Jacqueline can be contacted via phone (314) 286-4545.

Contact Information

Primary practice address
4219 Laclede Ave Suite B Saint Louis MO 63108-2814
Phone: (314) 286-4545
Fax: (314) 286-4542
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health, Adult 163WP0809X 073190 Missouri

Profile Details

NPI number 1851600233
LBN Legal business name Henderson, Jacqueline
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 1st, 2010
Last updated Oct 1st, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851600233 NPPES
Missouri Other 073190 MISSOURI STATE BOARD OF NURSING

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