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General NPI Number Information
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NPI Number | 1740086628
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Entity Type | Individual
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Provider Name | ABIGAIL MARIE HENDERSON NP
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Gender | Female
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 683 BIELENBERG DR STE 103
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City | WOODBURY
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State | MN
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Zip | 55125-1711
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Country | US
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Telephone | 952-841-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 7670 INSKIP TRL S
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City | COTTAGE GROVE
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State | MN
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Zip | 55016-2059
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Country | US
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Telephone | 651-380-8148
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 2482591
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 1121914-30
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 17107-33
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 13170
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License Number State | MN
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