MEDICARE: JANE 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
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.022335	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093204323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE HENDERSON

Provider Business Mailing Address
First Line	:	2139 RANDOM DR
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44904-1689
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	540 S TRIMBLE RD
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44906-3418
Country	:	US
Telephone Number	:	419-522-5454
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2018
Last Update Date	:	03/17/2026

Similar Medicare Providers

1720066103 — DR. DANIEL D BURWELL DO
Practice Location Address:

558 S TRIMBLE RD
MANSFIELD, OH
44906-3418

Practice Phone: 419-524-1410
Practice Fax: 419-524-2202

1326009945 — DR. LAWRENCE L GIBSON MD
Practice Location Address:

536 S TRIMBLE RD
MANSFIELD, OH
44906-3418

Practice Phone: 419-756-8899
Practice Fax: 419-756-6004

1508808395 — ASHLAND/MANSFIELD FOOT & ANKLE SPECIALISTS
Practice Location Address:

550 S TRIMBLE RD
MANSFIELD, OH
44906-3418

Practice Phone: 419-756-1961
Practice Fax: 419-774-9145

1376586651 — BRIAN J ZIMMERMAN DPM
Practice Location Address:

550 S TRIMBLE RD
MANSFIELD, OH
44906-3418

Practice Phone: 419-756-1961
Practice Fax: 419-774-9145

1629184791 — DR. RICHARD DALE NICHOLS DDS
Practice Location Address:

552 S TRIMBLE RD
MANSFIELD, OH
44906-3418

Practice Phone: 419-756-0188
Practice Fax: 419-774-9671

1821141102 — MANSFIELD IMAGING CENTER LLC
Practice Location Address:

536 S TRIMBLE RD , SUITE A
MANSFIELD, OH
44906-3418

Practice Phone: 419-774-9729
Practice Fax: 419-774-0006

Directions to “ JANE HENDERSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.