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NPI Code Detail

MEDICARE: DEBORAH HENDERSON

MEDICARE: DEBORAH HENDERSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1053670042
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH HENDERSON
Provider Business Mailing Address
First Line : 5513 ILLINOIS AVE NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-2937
Country : US
Telephone Number : 202-882-9310
Fax Number :
Provider Business Practice Location Address
First Line : 5513 ILLINOIS AVE NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-2937
Country : US
Telephone Number : 202-882-9310
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2012
Last Update Date : 05/10/2012

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Directions to “ DEBORAH HENDERSON ” Practice Location

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