Provider Demographics
NPI:1730678483
Name:HENDERSON, JULIE SLOAN (APRN)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:SLOAN
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:876 CUMMINGS LN
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75501-2194
Mailing Address - Country:US
Mailing Address - Phone:903-277-0109
Mailing Address - Fax:800-856-3042
Practice Address - Street 1:876 CUMMINGS LN
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-2194
Practice Address - Country:US
Practice Address - Phone:903-277-0109
Practice Address - Fax:800-856-3042
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137476363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily