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NPI Code Detail

MEDICARE: TRAVIS EDWARD HENDERSON DNP, PMHNP-BC

MEDICARE: TRAVIS EDWARD HENDERSON DNP, PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner266188AZ
2163W00000XRegistered Nurse266188AZ

General Provider Information

NPI Number : 1952022063
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRAVIS EDWARD HENDERSON DNP, PMHNP-BC
Provider Business Mailing Address
First Line : 39580 S LAGO DEL ORO PKWY
Second Line :
City : TUCSON
State : AZ
Zip : 85739-1091
Country : US
Telephone Number : 520-800-0755
Fax Number :
Provider Business Practice Location Address
First Line : 39580 S LAGO DEL ORO PKWY
Second Line :
City : TUCSON
State : AZ
Zip : 85739-1091
Country : US
Telephone Number : 520-800-0755
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2022
Last Update Date : 06/14/2026

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