Provider Demographics
NPI:1184383341
Name:HENDERSON, HOPE ANN (DEM)
Entity type:Individual
Prefix:MRS
First Name:HOPE
Middle Name:ANN
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:DEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4630 S QUAIL PARK DR APT H
Mailing Address - Street 2:
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84117-7998
Mailing Address - Country:US
Mailing Address - Phone:385-210-6997
Mailing Address - Fax:
Practice Address - Street 1:4630 S QUAIL PARK DR APT H
Practice Address - Street 2:
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84117-7998
Practice Address - Country:US
Practice Address - Phone:385-210-6997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay