Healthcare Provider Details

I. General information

NPI: 1609446574
Provider Name (Legal Business Name): VERONIKA NASHAWN HENDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2021
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8275 JUDGES WAY # 100
FRISCO TX
75036-1293
US

IV. Provider business mailing address

711 W BROAD ST
FORNEY TX
75126-9130
US

V. Phone/Fax

Practice location:
  • Phone: 469-737-9271
  • Fax: 469-225-8594
Mailing address:
  • Phone: 316-636-2888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1169722
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: