| Doctor Name: | MS. VESTA LEE HENDERSON |
| NPI Number: | 1245694140 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | RN2991522 |
| Business Practice Address: | 2900 Veterans Way Viera, FL - 329408007 |
| Business Phone Number: | 3216373788 |
| Business Fax Number: | |
| Mailing Address: | 346 Beach Park Ln, CAPE CANAVERAL |
| State: | FL |
| Postal Code: | 329205031 |
| Phone Number: | 2072539385 |
| Fax Number: | |
| NPI Enumeration Date: | 04/07/2016 |
| NPI Last Update Date: | 04/07/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP2201X |
| License Number: | RN2991522 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Ambulatory Care |
| Taxonomy Definition: | |