DR. KELLIE N HENDERSON (NPI# 1184850984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184850984 |
| Entity Type | Individual |
| Full Name | DR. KELLIE N HENDERSON |
| Credential | PHARMD, BCNSP |
| Practice Address |
1611 Nw 12th Ave Et-b069 Miami FL 33136-1005 |
| Practice Telephone | 3055856651 |
| Mailing Telephone | 3055856651 |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2009-06-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835N1003X |
Pharmacist Specialization: Nutrition Support |
PS28015 | FL | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548746399 | Kellie Henderson | Registered Nurse | 7500 Rolling Brook Dr Apt 512, Frisco, TX 75034-5446 | 2018-07-16 |
| 1720459621 | Kellie Cain Henderson | Nurse Practitioner | 1100 Northside Forsyth Dr, Suite 330, Cumming, GA 30041-6012 | 2015-10-18 |
| 1225145865 | Kellie Lawrence Henderson | Physician Assistant | 1508 Tombras Ave, East Ridge, TN 37412-2720 | 2006-08-23 |
| Street Address |
1611 NW 12TH AVE ET-B069 |
| City | MIAMI |
| State | FL |
| Zip Code | 33136-1005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740286251 | Karen Chitty | Emergency Medicine | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2005-06-21 |
| 1558968263 | Natalie Dinger | Nurse Practitioner | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-10-06 |
| 1306452057 | Ryan M Bukhari | Dentist | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-09-18 |
| 1467068155 | Hussien Touny | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-09-18 |
| 1912512310 | Clementina Aurora Cabrera | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-09-11 |
| 1184237265 | Kencya Toussaint | Nurse Practitioner | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-08-28 |
| 1568075976 | Manuel Molina | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-08-25 |
| 1063025468 | Carlos Federico Moral Ortega | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1096 | 2020-08-25 |
| 1770195919 | Ezekiel Oluwasayo Ijaopo | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-08-19 |
| 1568070258 | Virosh Dharmadasa | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2020-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548875685 | Agustina Dirocco | Registered Nurse | 1611 Ne 12th Ave, Miami, FL 33136 | 2020-09-15 |
| 1093338451 | Krizia Amy Vinck | Clinical Neuropsychologist | 1150 Nw 14th St, Miami, Fl 33136, Miami, FL 33136 | 2020-05-20 |
| 1992327761 | Jorge Luis Cardenas Alvarez | Student in an Organized Health Care Education/Training Program | 1611 Nw 12 Avenue Central Room 600-d, Miami, FL 33136 | 2020-05-14 |
| 1104447036 | Denver Steven Pinto | Student in an Organized Health Care Education/Training Program | 1611 Nw 12 Avenue Jackson Memorial Hospital, West Wing 279 Emergency Radiology, Miami, FL 33136 | 2020-05-01 |
| 1992325724 | Dimple Kumar Chanamolu | Student in an Organized Health Care Education/Training Program | Deptarment of Urology University of Miama Miller School, Crb 1120 Nw 14th Street Suite 1551c, Miami, FL 33136 | 2020-04-22 |
| 1578100996 | Alex Aziz Al Khoury | Internal Medicine | 1120 Nw 14th St. Suite 1112, Miami, FL 33136 | 2019-12-04 |
| 1437708872 | Marie Jeanjean | Genetic Counselor, MS | 1501 Nw 10th Avenue, Brb 334 (m860), Miami, FL 33136 | 2019-09-09 |
| 1710543905 | Tal Friehmann | Student in an Organized Health Care Education/Training Program | Jackson Memorial Hospital, Breast Imaging Dep, 1611 Nw 12 Avenue, Miami, FL 33136 | 2019-05-14 |
| 1285297895 | Omar Munoz | Student in an Organized Health Care Education/Training Program | 1611 Nw 12th Av., Psychiatry Department, Miami, FL 33136 | 2019-04-18 |
| 1902369648 | Seyedeh Haleh Amirian | Student in an Organized Health Care Education/Training Program | 1611 12th Avenue, Holtz Buiding, East Tower, 2169, Miami, FL 33136 | 2019-04-10 |
| Find all providers in zip 33136 | ||||
| Taxonomy Code | 1835N1003X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Nutrition Support |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in maintenance and/or restoration of optimal nutritional status, designing and modifying treatment according to patient needs. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992021760 | Joe Arthur Hooker Jr. | Pharmacist | 2115 Highway 60 Ste 200, Miami, AZ 85539-8744 | 2010-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821244831 | Jeffrey Brent Greer | Pharmacist | 7125 S Tropical Trl, Merritt Island, FL 32952-6608 | 2008-08-09 |
| 1730124603 | Monica Turnblacer | Pharmacist | 4073 Se Fairway E, Stuart, FL 34997-6172 | 2006-06-17 |
| 1477525228 | Dana Ayscue Brown | Pharmacist | 200 2nd St, West Palm Beach, FL 33401-4702 | 2006-02-06 |
| 1447242896 | David L Joffe | Pharmacist | 107 11th Ave N, St Petersburg, FL 33701-1821 | 2005-08-19 |
| 1932502036 | Right Medication Solutions, Inc. | Pharmacist | 2385 Nw Executive Center Dr, Suite 100, Boca Raton, FL 33431-8579 | 2014-10-02 |
| 1215277843 | Rocco John Ballacchino | Pharmacist | 1117 Washington St, Hollywood, FL 33019-1925 | 2013-02-19 |
| 1528304151 | William Graybeal | Pharmacist | 376 Northlake Blvd, Suite 1008, Altamonte Springs, FL 32701-5261 | 2012-12-31 |
| 1346547346 | Joelle M Moliere | Pharmacist | 4501 Nw 31st Ave, Oakland Park, FL 33309-3403 | 2011-02-28 |
| 1336386788 | Elena S Bensonoff | Pharmacist | 4330 S Manhattan Ave, Tampa, FL 33611-1304 | 2009-01-07 |
| 1174712053 | Onyema A. Ezeanya | Pharmacist | 575 10th St E, Palmetto, FL 34221-4013 | 2007-10-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.