MRS. KELLI HENDERSON (NPI# 1720252489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720252489 |
| Entity Type | Individual |
| Full Name | MRS. KELLI HENDERSON |
| Credential | RN |
| Practice Address |
510 Lincoln Dr Herrin IL 62948-6334 |
| Mailing Address |
1705 Redbud Ln Marion IL 62959-1536 |
| Practice Telephone | 6189973100 |
| Mailing Telephone | 6189262263 |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2008-04-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WX0800X |
Registered Nurse Specialization: Orthopedic |
IL | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326426982 | Kelli Henderson | Counselor | 5500 E Yale Ave Ste 202, Denver, CO 80222-6930 | 2015-05-14 |
| 1275180069 | Kelli Henderson | Student in an Organized Health Care Education/Training Program | 2119 Orchard Ave, Grand Junction, CO 81501-6753 | 2019-08-26 |
| 1194003392 | Kelli Samantha Henderson | Case Manager/Care Coordinator | 3407 Shamrock Ct, Gautier, MS 39553-6429 | 2011-07-22 |
| 1497961338 | Kelli Henderson | Dentist | 1425 Wakarusa Dr, Suite D, Lawrence, KS 66049-3832 | 2007-05-15 |
| Street Address |
510 LINCOLN DR |
| City | HERRIN |
| State | IL |
| Zip Code | 62948-6334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023001377 | Southern Illinois Orthopedic Center,llc | Clinic/Center | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2005-08-23 |
| 1629682471 | Rachel Peterson | Physical Therapist | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2020-08-31 |
| 1679119572 | Marcia Skinner | Physical Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-26 |
| 1790321602 | Braden Reeves | Physical Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-26 |
| 1508402652 | Joshua Sheldon | Physical Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-25 |
| 1801432968 | Sydney Allen | Physical Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-25 |
| 1487290532 | Michelle Reed | Occupational Therapy Assistant | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-11-25 |
| 1689235715 | Michelle Steh | Nurse Practitioner | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2019-06-28 |
| 1427576180 | Amelie H Wilson | Physical Therapist | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2017-09-01 |
| 1790238160 | Kali Jo Moe | Nurse Practitioner | 510 Lincoln Dr, Herrin, IL 62948-6334 | 2016-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215307590 | Carmelito Miralles Caronongan | Pediatrics | 120 S. 11th St., Herrin, IL 62948 | 2015-09-30 |
| 1073995684 | Motaz R Wraikat | Preventive Medicine | 315 S 13th St Ste 3, Herrin, IL 62948 | 2015-06-19 |
| 1639427933 | Salim Hosein | Surgery | 317 S 14th St Ste 1, Herrin, IL 62948 | 2012-08-17 |
| 1962780288 | Pooja Sareen | Internal Medicine | 3024 S Park Avenue, Herrin, IL 62948 | 2011-08-03 |
| 1235459918 | Timoteo Castro Md & Josefina D. Castro Md Ltd | Family Medicine | 321 South 13st St., Herrin, IL 62948 | 2010-06-04 |
| 1457501926 | Don Cassidy Arnold II | Urology | 220 S Park Ave Fl 2, Herrin, IL 62948 | 2008-09-22 |
| 1306094560 | Karl Keith Mitchener | Speech-Language Pathologist | 1901 N 13th Street, Herrin, IL 62948 | 2008-08-29 |
| 1457509705 | Kathryn Marie Bordenet-jines | Occupational Therapy Assistant | 1901 N. 13th, Herrin, IL 62948 | 2008-08-28 |
| 1417105776 | Cheryl Lynn Matic | Occupational Therapy Assistant | 1901 N. 13th St., Herrin, IL 62948 | 2008-08-28 |
| 1174771422 | Mary Frances Graham | Physical Therapy Assistant | 1901 N. 13th Street, Herrin, IL 62948 | 2008-08-28 |
| Find all providers in zip 62948 | ||||
| Taxonomy Code | 163WX0800X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225517303 | Rhonda L O'donoghue | Registered Nurse | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2018-08-09 |
| 1114388543 | Stephanie Jo Mcgeorge | Registered Nurse | 104 E Ashland Ave, Mount Zion, IL 62549-1271 | 2016-03-12 |
| 1558752881 | Roberta Reyes | Registered Nurse | 5841 S Maryland Ave, Mc3079, Chicago, IL 60637-1447 | 2015-02-09 |
| 1679977631 | Verenice J Velazquez | Registered Nurse | 2000 E Algonquin Rd, Suite 109, Schaumburg, IL 60173-4189 | 2014-10-20 |
| 1861810574 | Cindy M Spicka | Registered Nurse | 17850 Kedzie Ave, Suite #3250, Hazel Crest, IL 60429-2058 | 2014-03-31 |
| 1699100503 | Castle Orthopaedics and Sports Medicine | Registered Nurse | 2111 Ogden Ave, Aurora, IL 60504-7597 | 2013-09-10 |
| 1861827040 | Wayne Blume | Registered Nurse | 2111 Ogden Ave, Aurora, IL 60504-7597 | 2013-09-06 |
| 1053746230 | Frances Wirtz | Registered Nurse | 2111 Ogden Ave, Aurora, IL 60504-7597 | 2013-09-06 |
| 1851725485 | Carol A Mcguire | Registered Nurse | 2111 Ogden Ave, Aurora, IL 60504-7597 | 2013-08-30 |
| 1366876989 | Mary Farrell Milroy | Registered Nurse | 2111 Ogden Ave, Aurora, IL 60504-7597 | 2013-08-30 |
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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.