Mariah Henderson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN525862 Issued in OH

Practice address

325 W Siebenthaler Ave
Dayton, OH 45405-2243

Phone

(937) 367-4375

NPI assigned

Sep 8, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1164979068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W SIEBENTHALER AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454052243",
            "telephone_number": "937-367-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W SIEBENTHALER AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454052243",
            "telephone_number": "937-367-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MARIAH",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.155860-M-IV",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN525862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coleen Henderson, LISW-S
• Daniel Henderson, PEER SUPPORT
• Justin Luvalle Henderson, BSW,MSW
• Kevin Henderson
• Lannette Michelle Henderson, RN
• Naaseh Saba Henderson, LPN
• Lee Ralph Hendricks, DDS
• Savannah Hendricks
• Christopher Hendrickson
• Sarah Hendrickson, NP

• Registered Nurse in Dayton, OH
• Providers in Dayton, OH by specialty
• Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.