Provider Demographics
NPI:1053789453
Name:HENDERSON, ANITA YUAN-YI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:YUAN-YI
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PERRY POINT VA MEDICAL CENTER
Mailing Address - Street 2:
Mailing Address - City:PERRY POINT
Mailing Address - State:MD
Mailing Address - Zip Code:21092
Mailing Address - Country:US
Mailing Address - Phone:410-642-2411
Mailing Address - Fax:410-642-1122
Practice Address - Street 1:PERRY POINT VA MEDICAL CENTER
Practice Address - Street 2:119
Practice Address - City:PERRY POINT
Practice Address - State:MD
Practice Address - Zip Code:21092
Practice Address - Country:US
Practice Address - Phone:410-642-2411
Practice Address - Fax:410-642-1122
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD236741835P2201X
IN26026237A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist