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General NPI Number Information
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NPI Number | 1780576280
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Entity Type | Individual
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Provider Name | SEQUOIA HENRY
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Gender | Female
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 33 BEAVER DR STE 1
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City | DU BOIS
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State | PA
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Zip | 15801-2434
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Country | US
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Telephone | 814-503-8070
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Fax |
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Provider Business Mailing Address
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Address Line | 90 SPUR 64 RD
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City | CORSICA
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State | PA
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Zip | 15829-1232
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Country | US
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Telephone | 814-319-4615
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP033316
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License Number State | PA
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