Healthcare Provider Details

I. General information

NPI: 1073677282
Provider Name (Legal Business Name): JOANNA HENSCHEID PHCWHCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3304 COLORADO BLVD SUITE 102
DENTON TX
76210-6871
US

IV. Provider business mailing address

3304 COLORADO BLVD SUITE 102
DENTON TX
76210-6871
US

V. Phone/Fax

Practice location:
  • Phone: 940-387-6248
  • Fax: 940-381-1881
Mailing address:
  • Phone: 940-387-6248
  • Fax: 940-381-1881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number601133
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: