Henderson, Kenneth

Henderson, Kenneth is an individual health care provider with primary practice located at 2635 N 7Th St , Grand Junction CO 81501-8209. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care, which is considered as his primary health care specialty. Henderson, Kenneth can be contacted via phone (970) 298-2279.

Contact Information

Primary practice address
2635 N 7Th St Grand Junction CO 81501-8209
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care 363LN0005X APN.0994788-NP Colorado

Profile Details

NPI number 1770136988
LBN Legal business name Henderson, Kenneth
Credentials MSN, APRN, NNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2019
Last updated Jul 17th, 2019 - about 5 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 1770136988 NPPES
Colorado MEDICAID 14476351

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