Provider Demographics
NPI:1851021083
Name:HENDERSON BIRTH AND WELLNESS, PLLC
Entity Type:Organization
Organization Name:HENDERSON BIRTH AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DURHAM
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, CNM
Authorized Official - Phone:270-577-9333
Mailing Address - Street 1:319 8TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-2963
Mailing Address - Country:US
Mailing Address - Phone:270-830-3056
Mailing Address - Fax:270-830-3058
Practice Address - Street 1:319 8TH ST STE C
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-2963
Practice Address - Country:US
Practice Address - Phone:270-830-3056
Practice Address - Fax:270-830-3058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-11
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center