| Doctor Name: | MALINDA TERESA HENDERSON |
| NPI Number: | 1427159854 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | R100511-4 |
| Business Practice Address: | 100 Freeman Dr Saint Peter, MN - 560823504 |
| Business Phone Number: | 5079317125 |
| Business Fax Number: | 5079317126 |
| Mailing Address: | 100 Freeman Dr, SAINT PETER |
| State: | MN |
| Postal Code: | 560823504 |
| Phone Number: | 5079317125 |
| Fax Number: | 5079317126 |
| NPI Enumeration Date: | 09/26/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R100511-4 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |