| Doctor Name: | JENNIFER LYNN HENDERSON |
| NPI Number: | 1093836033 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, CDE |
| License Number: | 11824 |
| Business Practice Address: | 222 Tongass Dr Sitka, AK - 998359416 |
| Business Phone Number: | 9079668595 |
| Business Fax Number: | 9079668848 |
| Mailing Address: | 222 Tongass Dr, SITKA |
| State: | AK |
| Postal Code: | 998359416 |
| Phone Number: | 9079668595 |
| Fax Number: | 9079668848 |
| NPI Enumeration Date: | 04/03/2007 |
| NPI Last Update Date: | 07/15/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | 11824 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |