Lydia J Henderson, BSN, RN

Individual provider Active NPI Home Health Registered Nurse · West Alexandria, OH

NPI 1104337252 · NPPES record last updated Oct 17, 2017

Key facts

NPI
1104337252
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
RN.443724 (OH)
Practice address
52 E Oak St
West Alexandria, OH 45381-1273
Phone
(937) 715-2068
NPI assigned
Oct 17, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.443724OHMDHome Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X RN.443724 OH Yes

Addresses

Primary practice location

52 E Oak St
West Alexandria, OH 45381-1273

Mailing address

52 E Oak St
West Alexandria, OH 45381-1273
Phone (937) 715-2068

Other providers in West Alexandria, OH

All providers in West Alexandria, OH · Home Health Registered Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.