Provider Demographics
NPI:1225865850
Name:HENDERSON, YOLANDA EMERALD
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:EMERALD
Last Name:HENDERSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W BROADWAY STE 37
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-9019
Mailing Address - Country:US
Mailing Address - Phone:712-828-5240
Mailing Address - Fax:515-495-6700
Practice Address - Street 1:300 W BROADWAY STE 37
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-9019
Practice Address - Country:US
Practice Address - Phone:712-828-5240
Practice Address - Fax:515-495-6700
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide