| Doctor Name: | KATHLEEN HENDERSHOT |
| NPI Number: | 1093846958 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | RN32023 |
| Business Practice Address: | 4705 Old Post Rd Unit A Charlestown, RI - 028131842 |
| Business Phone Number: | 4013647705 |
| Business Fax Number: | 4013643310 |
| Mailing Address: | Po Box 899, CHARLESTOWN |
| State: | RI |
| Postal Code: | 028130899 |
| Phone Number: | 4013647705 |
| Fax Number: | 4013649104 |
| NPI Enumeration Date: | 03/09/2007 |
| NPI Last Update Date: | 05/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0809X |
| License Number: | RN32023 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | RI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |