Healthcare Provider Details

I. General information

NPI: 1205852027
Provider Name (Legal Business Name): BARBARA JOAN HENDERSON APN,RNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1622 CAMPUS AVE
HARRISON AR
72601-5524
US

IV. Provider business mailing address

PO BOX 266
LESLIE AR
72645-0266
US

V. Phone/Fax

Practice location:
  • Phone: 870-743-5244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberA01088
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: