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LATESHIA HENDERSON FNP
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1316484074
Individual Registrant: LATESHIA HENDERSON FNP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
1402 BAILEY AVE NEEDLES, CA 92363-3104 US
Tel: 760-326-0222 Fax: --
Tel: 760-326-0222 Fax: --
Contact information for business:
1402 BAILEY AVE NEEDLES, CA 92363-3104 US
Tel: 760-326-0222 Fax: --
Tel: 760-326-0222 Fax: --
Registration Information:
NPI: 1316484074
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | CA | 95005819 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
