MEDICARE: LAURA JEAN HENDERSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	358542	NY

General Provider Information

NPI Number	:	1134944226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA JEAN HENDERSON

Provider Business Mailing Address
First Line	:	830 WASHINGTON ST
Second Line	:
City	:	WATERTOWN
State	:	NY
Zip	:	13601-4034
Country	:	US
Telephone Number	:	315-785-4673
Fax Number	:	315-788-4248

Provider Business Practice Location Address
First Line	:	830 WASHINGTON ST
Second Line	:
City	:	WATERTOWN
State	:	NY
Zip	:	13601-4034
Country	:	US
Telephone Number	:	315-785-4673
Fax Number	:	315-788-4248

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2024
Last Update Date	:	06/04/2026

Similar Medicare Providers

1871597724 — DORIS ELAINE GRIMES CRNA
Practice Location Address:

830 WASHINGTON ST
WATERTOWN, NY
13601-4034

Practice Phone: 315-449-0513
Practice Fax:

1861499196 — MRS. LISA M WESTCOTT NP
Practice Location Address:

830 WASHINGTON ST
WATERTOWN, NY
13601-4034

Practice Phone: 315-785-4102
Practice Fax:

1568444651 — JARMILA SLEZKOVA M.D.
Practice Location Address:

830 WASHINGTON ST
WATERTOWN, NY
13601-4034

Practice Phone: 315-785-8509
Practice Fax: 315-785-8619

1104809409 — MS. ERICA TINE-ROSE FEOLA P.A.
Practice Location Address:

830 WASHINGTON ST , ER DEPARTMENT
WATERTOWN, NY
13601-4034

Practice Phone: 315-786-4813
Practice Fax: 315-786-4314

1568447803 — DAVID V REINDL MD
Practice Location Address:

830 WASHINGTON ST , SAMARITAN MEDICAL CENTER MEDICAL STAFF OFFICE
WATERTOWN, NY
13601-4034

Practice Phone: 315-786-4824
Practice Fax: 315-786-4915

1215909312 — DR. DAVID R. SMITH
Practice Location Address:

830 WASHINGTON ST
WATERTOWN, NY
13601-4034

Practice Phone: 315-785-4313
Practice Fax: 315-779-5114

Directions to “ LAURA JEAN HENDERSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.