Kathleen Ann Henderson, RN

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

53-77431-122 Issued in KS

Practice address

9100 W 74TH St
Shawnee Mission, KS 66204-4004

Phone

(913) 632-2831

Fax

(913) 632-2898

NPI assigned

Mar 18, 2020

Last updated

Mar 18, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1584489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1285260570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 N PRINCE EDWARD IS",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660616702",
            "telephone_number": "913-461-4747",
            "fax_number": "913-632-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 W 74TH ST",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662044004",
            "telephone_number": "913-632-2831",
            "fax_number": "913-632-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-18",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "KS",
            "license": "53-77431-122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Clinical Nurse Specialist in Shawnee Mission, KS
• Providers in Shawnee Mission, KS by specialty
• Adult Health Clinical Nurse Specialist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; 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.