LEANDRA R HENDERSON APN NPI 1740443084

NPI Information

NPI: 1740443084
Provider Name: LEANDRA R HENDERSON, APN
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Organization: SBH-KINGSPORT

PECOS Registration: Yes

Address:
403 N STATE OF FRANKLIN RD
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 431-7047
Get Directions

Leandra R Henderson, APN is a psychiatric/mental health nurse practitioner in Johnson City, TN with 14 years of experience. Leandra R Henderson, APN NPI is 1740443084. 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:

403 N STATE OF FRANKLIN RD
JOHNSON CITY, TN
ZIP 37604-034
Phone: (423) 431-7047
Fax: (423) 979-0569

The NPI 1740443084 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/8/2008 and was last updated on 4/3/2019.

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	363LF0000X	Nurse Practitioner	Family	12527	TENNESSEE	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	12527	TENNESSEE	Yes
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	0024172842	VIRGIN ISLANDS	No

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	1506060	MEDICAID	TENNESSEE
2	1740443084	MEDICAID	VIRGINIA
3	3341833	MEDICAID	TENNESSEE
4	600951198	OTHER	TENNESSEE	MAGELLAN

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: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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