NPI 1013518174

Katara Jo Henderson

Practitioner Certified Registered Nurse Anesthetist Saint Paul, MN

Practice location

Address: 640 Jackson St, Saint Paul, MN 55101-2595
Phone: (651) 254-3456
Mailing address: 4128 Elliot Ave, Minneapolis, MN 55407-3149

Registered specialties (2)

Certified Registered Nurse Anesthetist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence 2566 (MN)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1013518174
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Nov 2020
Record last updated: 5 Feb 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.