Henderson, Kimberly E

Henderson, Kimberly E is an individual health care provider with primary practice located at 520 Nw 5Th St , Brainerd MN 56401-2902. 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, Kimberly E can be contacted via phone (507) 884-4856.

Contact Information

Primary practice address
520 Nw 5Th St Brainerd MN 56401-2902
Phone: (507) 884-4856
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 996 Minnesota

Profile Details

NPI number 1114991361
LBN Legal business name Henderson, Kimberly E
Credentials APRN, CNP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Jan 10th, 2023 - about last year

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 1114991361 NPPES
Minnesota MEDICAID 313637000

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