1205852027 NPI number — MS. BARBARA JOAN HENDERSON APN,RNP

Table of content: (NPI 1528490653)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205852027 NPI number — MS. BARBARA JOAN HENDERSON APN,RNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HENDERSON
Provider First Name:
BARBARA
Provider Middle Name:
JOAN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
APN,RNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205852027
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 266
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LESLIE
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72645-0266
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1622 CAMPUS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISON
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72601-5524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-743-5244
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LW0102X , with the licence number:  A01088 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com