Henderson, Jamie Lynn

Henderson, Jamie Lynn is an sole proprietor health care provider with primary practice located at 707 N Michigan St Ste 400 , South Bend IN 46601-1071. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Henderson, Jamie Lynn can be contacted via phone (574) 647-8470.

Contact Information

Primary practice address
707 N Michigan St Ste 400 South Bend IN 46601-1071
Phone: (574) 647-8470
Fax: (574) 647-8475
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 28215294A Indiana

Profile Details

NPI number 1194505206
LBN Legal business name Henderson, Jamie Lynn
Credentials PMHNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 5th, 2023
Last updated Jan 8th, 2024 - about 11 months 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1194505206 NPPES
Indiana MEDICAID 300084195

Popular Providers