HOLLY JO HENDERSON (NPI# 1710034954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1710034954 |
Entity Type | Individual |
Full Name | HOLLY JO HENDERSON |
Credential | MPT |
Practice Address |
102 Prairie Mills Rd Golden IL 62339-1055 |
Mailing Address |
183 Saturn Dr Hannibal MO 63401-2398 |
Practice Telephone | 2176964446 |
Mailing Telephone | 5737950849 |
Enumeration Date | 2007-01-03 |
Last Update Date | 2020-01-31 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209020158 | IL | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225658180 | Holly A Henderson | Counselor | 600 40th St N Apt 208, St Petersburg, FL 33713-6340 | 2020-04-21 |
1811389620 | Holly Jo Henderson | Counselor | 1701 Townsend St, Cassville, MO 65625-1451 | 2015-03-03 |
1891138541 | Holly Norma Henderson | Social Worker | 516 S Creyts Rd, Ste F, Lansing, MI 48917-8268 | 2013-04-12 |
1720692080 | Holly Henderson | Counselor | 3900 W Brown Deer Rd Ste 200, Brown Deer, WI 53209-1220 | 2020-09-03 |
Street Address |
102 PRAIRIE MILLS RD |
City | GOLDEN |
State | IL |
Zip Code | 62339-1055 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629099197 | Denman Country Drug | Pharmacist | 102 Prairie Mills Rd, Golden, IL 62339-0070 | 2006-07-21 |
1003432964 | Tracy Lynn Kurfman | Physical Therapy Assistant | 102 Prairie Mills Rd, Golden, IL 62339-1055 | 2020-06-17 |
1609213206 | Patricia Ann Steffen | Nurse Practitioner | 102 Prairie Mills Rd, Golden, IL 62339-1055 | 2013-05-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245392349 | Blessing Hospital | Clinic/Center | 102 Praire Mills Road, Golden, IL 62339 | 2006-12-14 |
1922109735 | Donna Gail | Nurse Practitioner | 102 Praire Mills Road, Golden, IL 62339 | 2006-09-26 |
1437473394 | Lindsey Dyan Stephens | Speech-Language Pathologist | 306 W. 3rd St., Golden, IL 62339-0021 | 2010-03-22 |
1326661166 | Jacqueline Evonne Hildebrand | Behavioral Analyst | 301 Albers St, Golden, IL 62339-1006 | 2020-05-27 |
1083238729 | Atlas Behavior Services | Behavioral Analyst | 301 Albers St, Golden, IL 62339-1006 | 2020-05-28 |
1134162399 | Golden Good Shepherd Home | Skilled Nursing Facility | 101 Prairie Mills Rd, Golden, IL 62339-1016 | 2006-06-14 |
1457546277 | Carrie R. Cook | Physical Therapist | 101 Prairie Mills Rd, Golden, IL 62339-1016 | 2007-09-14 |
1639364979 | Caremark Rehab, Ltd. | Occupational Therapist | 101 Prairie Mills Rd, Golden, IL 62339-1016 | 2007-09-10 |
1275726952 | Mark D Leverenz | Occupational Therapist | 101 Prairie Mills Rd, Golden, IL 62339-1016 | 2007-08-25 |
1205138955 | Laura Tenhouse | Developmental Therapist | 513 Warsaw St, Golden, IL 62339-1051 | 2010-12-01 |
Find all providers in zip 62339 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750832093 | Sonya Waganer | Nurse Practitioner | 14010 W 8th Ave, Golden, CO 80401-4517 | 2016-10-21 |
1760806673 | Richard Adamson | Nurse Practitioner | 1707 Cole Blvd Ste 100, Golden, CO 80401-3219 | 2014-02-12 |
1235403254 | Holly J Vali | Nurse Practitioner | 16713 W Archer Ave, Golden, CO 80401-6524 | 2012-03-08 |
1457561854 | Anne Porter Wilfong | Nurse Practitioner | 1225 17th St, Golden, CO 80401-1824 | 2007-05-23 |
1891843363 | Lisa Lees | Nurse Practitioner | 1278 Pomegranate Ln, Golden, CO 80401-9222 | 2007-01-08 |
1275134959 | Ritu Patel | Nurse Practitioner | 400 Indiana St Ste 280, Golden, CO 80401-5069 | 2020-11-08 |
1174138523 | Eliza Keating Slayman | Nurse Practitioner | 660 Golden Ridge Rd Ste 250, Golden, CO 80401-9541 | 2020-09-12 |
1689210221 | Erni Ruslie | Nurse Practitioner | 755 Heritage Rd Ste 100, Golden, CO 80401-3600 | 2019-11-19 |
1316427495 | Teresa Affrunti | Nurse Practitioner | 755 Heritage Rd Ste 100, Golden, CO 80401-3600 | 2018-08-17 |
1063920429 | Erin Ramsay | Nurse Practitioner | 5920 Mcintyre St, Golden, CO 80403-7445 | 2018-01-18 |
Find all providers in GOLDEN |
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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.