Provider Demographics
NPI:1073791786
Name:HENDERSON, JUDIANNE URMAZA (APRN, BC)
Entity Type:Individual
Prefix:MRS
First Name:JUDIANNE
Middle Name:URMAZA
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:APRN, BC
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Mailing Address - Street 1:MGH CANCER CANCER CENTER 55 FRUIT STREET
Mailing Address - Street 2:YAWKEY 7B
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-724-4000
Mailing Address - Fax:617-643-1915
Practice Address - Street 1:MGH CANCER CANCER CENTER 55 FRUIT STREET
Practice Address - Street 2:YAWKEY 7B
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-724-4000
Practice Address - Fax:617-643-1915
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA254899363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care