Freda Ann Henderson

Military Health Care Provider, Independent Duty Medical Technicians in Nellis Afb, NV. Individual provider (NPI-1).

NPI number1124253554

StatusActive

Last updated in NPPESJul 27, 2009

Details

NPI: 1124253554
Entity type: Individual (NPI-1)
Name: Ms. Freda Ann Henderson
Sex: Female
Sole proprietor: No
Enumeration date: May 29, 2009
Last updated: Jul 27, 2009

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
1710I1003X	Military Health Care Provider, Independent Duty Medical Technicians	–	–	Yes

Practice location

4250 Griffiss Ave
Nellis Afb, NV 89191-7018

Phone 702-404-1142

Mailing address

4250 Griffiss Ave
Nellis Afb, NV 89191-7018

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Independent Duty Medical Technicians providers in Nellis Afb, NV

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