Basic Information
| Provider Information | |||||||||
| NPI: | 1013260421 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HENDERSON | ||||||||
| FirstName: | VERONICA | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 131 SAUNDERSVILLE RD STE 160 | ||||||||
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| City: | HENDERSONVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370758940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158243737 | ||||||||
| FaxNumber: | 8555404722 | ||||||||
| Practice Location | |||||||||
| Address1: | 4355 FERGUSON DR | ||||||||
| Address2: | SUITE 270 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452455136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137180115 | ||||||||
| FaxNumber: | 8555404722 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2012 | ||||||||
| LastUpdateDate: | 07/10/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | F0912131 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 208VP0000X | COA.14058-NP | OH | Y | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine |
No ID Information.