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NPI Code Detail

MEDICARE: KATHERINE ANN HENRY FNP

MEDICARE: KATHERINE ANN HENRY FNP
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
1363L00000XNurse Practitioner241078TX
2363LF0000XFamily Nurse Practitioner241078TX
3363L00000XNurse PractitionerCNP-02049NM
4363LP0200XPediatric Nurse Practitioner241078TX
5363L00000XNurse PractitionerAP110588TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134127160
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE ANN HENRY FNP
Provider Business Mailing Address
First Line : PO BOX 26666
Second Line : PROVIDER ENROLLMENT
City : ALBUQUERQUE
State : NM
Zip : 87125-6666
Country : US
Telephone Number : 505-923-6770
Fax Number :
Provider Business Practice Location Address
First Line : 1000 CRAIG DR
Second Line :
City : AMARILLO
State : TX
Zip : 79106-4015
Country : US
Telephone Number : 806-331-7905
Fax Number : 806-731-1516
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2005
Last Update Date : 01/15/2019

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Directions to “ KATHERINE ANN HENRY FNP” Practice Location

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