Marni Marie Henderson, B.S.

Primary specialty

Health EducatorTaxonomy code 174H00000X

License

174H00000X Issued in MA

Practice address

6393 S Red Shine Way
Boise, ID 83709-6509

Phone

(208) 440-1230

NPI assigned

Mar 23, 2016

Last updated

Mar 23, 2016By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1902268527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6393 S RED SHINE WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837096509",
            "telephone_number": "208-440-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6393 S RED SHINE WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837096509",
            "telephone_number": "208-440-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MARNI",
        "middle_name": "MARIE",
        "credential": "B.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "WA",
            "license": "B.S. COMMUNITY HEALT",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "MA",
            "license": "174H00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Kaitlyn Henderson, DPT
• Jessica Berry Henderson, PH.D., L.P.C
• Jessica D Henderson, LCSW
• Joan Marie Henderson, EDD
• Lindsay Henderson
• Spencer Dean Henderson, D.C.
• Susan Hendren, CNM
• Tyler Layton Hendricks, DDS
• Kimberly S. Hendrickson, OT
• Parker Jon Hendrickson, DPT

• Health Educator in Boise, ID
• Providers in Boise, ID by specialty
• Health Educator in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.