DR. NANINE S HENDERSON DO NPI 1376617183

NPI Information

NPI: 1376617183
Provider Name: DR. NANINE S HENDERSON, DO
Classification: Family Medicine - 207QA0401X
Entity Type: Individual

Specialization: Addiction Medicine

CLIA Number: 18D0936120

Address:
4010 DUPONT CIR
LOUISVILLE, KY
ZIP 40207
Phone: (502) 893-5422
Get Directions

DR. Nanine S Henderson, DO is an addiction medicine family medicine in Louisville, KY. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. DR. Nanine S Henderson, DO NPI is 1376617183. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4010 DUPONT CIR
LOUISVILLE, KY
ZIP 40207
Phone: (502) 893-5422
Fax: (502) 896-4962

The CLIA number assigned to this NPI record is 18D0936120 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/20/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0401X	Family Medicine	Addiction Medicine	02123	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C75254	MEDICARE UPIN
2	1404201	MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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