Healthcare Provider Details

I. General information

NPI: 1639081441
Provider Name (Legal Business Name): DENITA HENDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 CHANCER LN
SLIDELL LA
70461-4527
US

IV. Provider business mailing address

5050 TOULON ST
NEW ORLEANS LA
70129-1122
US

V. Phone/Fax

Practice location:
  • Phone: 504-232-1241
  • Fax:
Mailing address:
  • Phone: 504-232-1241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: