Provider Demographics
NPI:1306071840
Name:HENDERSON, KARIN C (PA)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:C
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KARIN
Other - Middle Name:C
Other - Last Name:SCHONBACHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:8840 COMMERCE PARK PL STE E
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-3129
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13250 HAZEL DELL PKWY STE 104
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-8527
Practice Address - Country:US
Practice Address - Phone:317-415-6117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10001093A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant