Doctor Name: | MR. KATINA LENEIL HENDERSON |
NPI Number: | 1114992930 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N. |
License Number: | 116976 |
Business Practice Address: | 1650 Cochrane Cir Ft Carson, CO - 809134603 |
Business Phone Number: | 7195242047 |
Business Fax Number: | 7195243526 |
Mailing Address: | 1650 Cochrane Cir, FT CARSON |
State: | CO |
Postal Code: | 809134603 |
Phone Number: | 7195267649 |
Fax Number: | 7195267019 |
NPI Enumeration Date: | 02/23/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WG0000X |
License Number: | 116976 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | General Practice |
Taxonomy Definition: |