# MARISSA LYNNE HENDERSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1518502475
- **Gender:** F
- **Credential:** MSN, APRN, FNP-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 10041652 | OR | — |
| 363L00000X | Nurse Practitioner | 2025008125 | MO | — |
| 363L00000X | Nurse Practitioner | 232324 | AR | — |
| 363L00000X | Nurse Practitioner | 3-002294 | AL | — |
| 363L00000X | Nurse Practitioner | 30139 | SC | — |
| 363L00000X | Nurse Practitioner | 322525 | AZ | — |
| 363L00000X | Nurse Practitioner | 38496 | TN | — |
| 363L00000X | Nurse Practitioner | 4035650 | KY | — |
| 363L00000X | Nurse Practitioner | 907312 | MS | — |
| 363L00000X | Nurse Practitioner | AP143723 | TX | Yes |
| 363L00000X | Nurse Practitioner | AP61670672 | WA | — |
| 363L00000X | Nurse Practitioner | APRN11037949 | FL | — |
| 363L00000X | Nurse Practitioner | C-APN.0103933-C-NP | CO | — |
| 363L00000X | Nurse Practitioner | GAA-NP003247 | GA | — |
| 363L00000X | Nurse Practitioner | SP032352 | PA | — |

## Other

- **Enumeration date:** 11/14/2019
- **Last updated:** 09/22/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | PENDING | BCBS | TX |
| 05 | — | PENDING | — | TX |