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Contact Information

KELLEY HENDERSON, LAT, ATC
11000 UNIVERSITY PARKWAY
PENSACOLA, FL32514
 Phone: 817-257-5573
 Fax: 817-257-7702
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for KELLEY HENDERSON · (Female)

NPI Number 1952425514
Status Active
Credentials LAT, ATC
Entity Individual
Enumeration date 03/19/2007
Last updated 12/12/2022 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # AL1031
  • TX License # AT3804
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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