| Doctor Name: | JENNIFER A HENDERSON |
| NPI Number: | 1134479272 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | ATP-000492 |
| Business Practice Address: | 146 Passion Play Rd Ste A Eureka Springs, AR - 726329455 |
| Business Phone Number: | 4792539746 |
| Business Fax Number: | 4792532464 |
| Mailing Address: | 146 Passion Play Rd Ste A, EUREKA SPRINGS |
| State: | AR |
| Postal Code: | 726329455 |
| Phone Number: | 4792539746 |
| Fax Number: | 4792532464 |
| NPI Enumeration Date: | 09/17/2012 |
| NPI Last Update Date: | 09/17/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | ATP-000492 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |