Henderson, Melinda
Henderson, Melinda is an individual health care provider with primary practice located at 7801 N Knoxville Ave , Peoria IL 61614-2076. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Henderson, Melinda can be contacted via phone (309) 692-6088.Contact Information
Primary practice address
7801 N Knoxville Ave
Peoria IL 61614-2076
Phone: (309) 692-6088
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | Illinois |
Profile Details
| NPI number | 1679516561 |
|---|---|
| LBN Legal business name | Henderson, Melinda |
| Credentials | C-FNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679516561 | NPPES |
| Illinois | Other | IL01Q9 | JOHN DEERE |
| Illinois | Other | 073083 | JOHN DEERE |
| Illinois | Other | 472310 | JOHN DEERE |
| Illinois | Other | 7215059 | JOHN DEERE |
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