Doctor Name: | MS. VIVIAN LYNN HENDERSON |
NPI Number: | 1205239175 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CERTIFIED MEDICAL AS |
License Number: | 777218 |
Business Practice Address: | 167 North Main Street Tuba City, AZ - 860450600 |
Business Phone Number: | 9282832501 |
Business Fax Number: | 9282832677 |
Mailing Address: | Po Box 600, Pfs Business Office TUBA CITY |
State: | AZ |
Postal Code: | 860450600 |
Phone Number: | 9282832781 |
Fax Number: | 9282832677 |
NPI Enumeration Date: | 10/06/2014 |
NPI Last Update Date: | 10/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 374U00000X |
License Number: | 777218 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Nursing Service Related Providers |
Taxonomy Classification: | Home Health Aide |
Taxonomy Specialization: | |
Taxonomy Definition: | A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes. |