Provider Demographics
NPI:1629839907
Name:HENDERSON-HUGHES, VENUS (MBA, MPH)
Entity Type:Individual
Prefix:
First Name:VENUS
Middle Name:
Last Name:HENDERSON-HUGHES
Suffix:
Gender:F
Credentials:MBA, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25033
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48909-5033
Mailing Address - Country:US
Mailing Address - Phone:623-349-1198
Mailing Address - Fax:
Practice Address - Street 1:6805 MILL WHEEL DR
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-7068
Practice Address - Country:US
Practice Address - Phone:480-430-2374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI183700000X, 174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No183700000XPharmacy Service ProvidersPharmacy Technician