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NPI Code Detail

MEDICARE: MAUREEN HENDERSON RN

MEDICARE: MAUREEN HENDERSON RN
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
1163W00000XRegistered Nurse74613CO

General Provider Information

NPI Number : 1578506648
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAUREEN HENDERSON RN
Provider Business Mailing Address
First Line : PO BOX 302
Second Line :
City : CALHAN
State : CO
Zip : 80808-0302
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1650 COCHRANE CIR
Second Line :
City : FT CARSON
State : CO
Zip : 80913-4603
Country : US
Telephone Number : 719-526-7030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2006
Last Update Date : 01/25/2026

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