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General NPI Number Information
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NPI Number | 1669272795
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Entity Type | Organization
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Legal Business Name | HENDERSHOT WELLNESS CENTER LLC
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 235 E MARKET ST
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City | CLEARFIELD
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State | PA
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Zip | 16830-2424
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Country | US
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Telephone | 814-577-5875
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Fax |
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Provider Business Mailing Address
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Address Line | 235 E MARKET ST
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City | CLEARFIELD
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State | PA
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Zip | 16830-2424
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Country | US
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Telephone | 814-205-4957
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Fax | 814-205-4090
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Authorized Official
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Title or Position | OWNER
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Name | EMILY WARRICK
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Credential | CRNP
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Telephone | 814-205-4957
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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