Active NPI
Kristin Walker Henderson, BSN, RN, CCM
- Case Management Registered Nurse
- Fort Rucker, AL
National Provider Identifier
1093261232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Registered Nurse
- License
- 1-113449
- Practice address
- 301 Andrews Avenue
Fort Rucker, AL 36362 - Phone
- (334) 255-7200
- NPI assigned
- Aug 28, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1-113449 | AL | |
| Case Management Registered Nurse | 163WC0400X | 1-113449 | AL | Primary |
Addresses
Primary practice location
301 Andrews Avenue
Fort Rucker, AL 36362
Mailing address
301 Andrews Avenue
Fort Rucker, AL 36362
Phone (334) 255-7200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-113449 | AL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643760000000",
"number": "1093261232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 ANDREWS AVENUE",
"city": "FORT RUCKER",
"state": "AL",
"postal_code": "36362",
"telephone_number": "334-255-7200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 ANDREWS AVENUE",
"city": "FORT RUCKER",
"state": "AL",
"postal_code": "36362",
"telephone_number": "334-255-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "KRISTIN",
"middle_name": "WALKER",
"name_prefix": "Mrs.",
"credential": "BSN, RN, CCM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-28",
"last_updated": "2022-02-02",
"certification_date": "2022-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AL",
"license": "1-113449",
"primary": false
},
{
"code": "163WC0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Case Management",
"state": "AL",
"license": "1-113449",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Rucker, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.