Provider Demographics
NPI:1740748839
Name:HENDERSON, BILLI ANN (RN)
Entity Type:Individual
Prefix:
First Name:BILLI
Middle Name:ANN
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9420 SCOT ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34669-1960
Mailing Address - Country:US
Mailing Address - Phone:727-505-3825
Mailing Address - Fax:
Practice Address - Street 1:9420 SCOT ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34669-1960
Practice Address - Country:US
Practice Address - Phone:727-505-3825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN3404462163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health