Provider Demographics
NPI:1033558101
Name:HENDERSON, TESSA SUZANNE (NP)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:SUZANNE
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TESSA
Other - Middle Name:SUZANNE
Other - Last Name:MEUNIER, HOULE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12596 W BAYAUD AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-2035
Mailing Address - Country:US
Mailing Address - Phone:303-649-3050
Mailing Address - Fax:
Practice Address - Street 1:12596 W BAYAUD AVE STE 100
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-2035
Practice Address - Country:US
Practice Address - Phone:303-649-3050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0990650-NP363LA2100X, 363LG0600X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO384572YQ3LOtherMEDICARE
CO384572YQN9OtherMEDICARE
CO384572YQPGOtherMEDICARE