Provider Demographics
NPI:1922328244
Name:HENDERSON, WENDY ANN (PHD, CRNP)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:ANN
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:PHD, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MEMORIAL DR
Mailing Address - Street 2:BLDG 9, 1W108 , MSC 0935
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:301-451-9534
Mailing Address - Fax:
Practice Address - Street 1:NATIONAL INSTITUTES OF CTR
Practice Address - Street 2:BUILDING 10, 10 CENTER DRIVE, 2-1339
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-451-9534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR181106363LP0200X
PASP005687D363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics