Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ammon Taylor Henderson

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1790646594

Ammon Taylor Henderson is a Student in an Organized Health Care Education/Training Program in Tulsa, Oklahoma. Practices as a sole proprietor. Licensed in Oklahoma.

Licensed in
OK
In the registry since
2025

Practice location Address checks out

1111 W 17th St
Tulsa, OK 74107-1886
Phone: (918) 582-1972
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (OK)

Record details

NPI number1790646594
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 20, 2025
Last updated in NPPESNovember 20, 2025
Certification dateNovember 20, 2025
Mailing address1325 Robins St Apt 6, Conway, AR 72034-6575

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