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

Mr. Ethan M Henderson, FNP-C

Individual provider Family Nurse Practitioner · NPI 1447817788

Mr. Ethan M Henderson, FNP-C is a Nurse Practitioner in Springfield, Missouri. Qualified in 2018, 8 years ago. Accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
8
Licensed in
MO
In the registry since
2019
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

3231 S National Ave Ste 170
Springfield, MO 65807-7304
Phone: (417) 885-0868
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 2019007535 (MO)

Record details

NPI number1447817788
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedMay 22, 2019
Last updated in NPPESJune 19, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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