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General NPI Number Information
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NPI Number | 1447026471
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Entity Type | Individual
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Provider Name | TASHIA HENDERSON BSN, RN
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Gender | Female
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Dates
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Enumeration Date | 11/30/2023
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 1900 E NORTHERN PKWY STE T6
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City | BALTIMORE
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State | MD
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Zip | 21239-2120
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Country | US
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Telephone | 443-438-6893
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Fax |
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Provider Business Mailing Address
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Address Line | 3266 KAISER DR
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-4555
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Country | US
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Telephone | 443-695-2491
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | R252616
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | R252616
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License Number State | MD
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