Healthcare Provider Details

I. General information

NPI: 1952216723
Provider Name (Legal Business Name): KATRIN HENRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11203 S FRONTAGE RD
YUMA AZ
85367-7875
US

IV. Provider business mailing address

12155 E CALLE ENTRADA
YUMA AZ
85367-9039
US

V. Phone/Fax

Practice location:
  • Phone: 928-342-1332
  • Fax:
Mailing address:
  • Phone: 928-259-6323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberI026531
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: