Nicole Bashee Henderson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703112391 Issued in MI

Practice address

25045 Glenbrooke Dr
Southfield, MI 48033-2513

Phone

(248) 632-0488

NPI assigned

Aug 31, 2023

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 31, 2023.

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1316723844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25045 GLENBROOKE DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480332513",
            "telephone_number": "248-632-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25045 GLENBROOKE DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480332513",
            "telephone_number": "248-632-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "NICOLE",
        "middle_name": "BASHEE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703112391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lesly Jane Hendershot, PSY.D., BCBA-D
• F Theresa Henderson, CRNA
• Kerisha Henderson
• Lauren Henderson, DO
• Lydell Jamal Henderson
• Sierra Kenan Hendrix-Williams
• Tiara Hendrix
• Madison Henley
• Toni Henning
• Nicole Henriksen

• All providers in Southfield, MI
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.