Heidi Henderson, PA

NPI #1558485938 in Peoria, Illinois

Provider Information

NPI Number: 1558485938
Entity Type: Individual
Name: Heidi Henderson, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Mar 19, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 221 NE GLEN OAK AVE
City: Peoria
State: Illinois
ZIP Code: 61636-0001
Phone: (309) 672-5733

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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