Provider Demographics
NPI:1447816921
Name:HENDERSON, MEGAN FRANCES
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:FRANCES
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 E 19TH AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1258
Mailing Address - Country:US
Mailing Address - Phone:720-748-4800
Mailing Address - Fax:720-748-4801
Practice Address - Street 1:1721 E 19TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1258
Practice Address - Country:US
Practice Address - Phone:720-748-4800
Practice Address - Fax:720-748-4801
Is Sole Proprietor?:No
Enumeration Date:2019-05-10
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1623672163W00000X
CO0994795363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse