# REFRESH AND RENEW WITH NURSE HENDERSON

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902750573
- **Authorized official:** IRULAN HENDERSON NP (CLINICIAN)
- **Authorized official phone:** (623) 204-6631

## Contact information

- **Practice address:** 1208 RED BUCKEYE CT, MONCKS CORNER, SC 29461-8600
- **Practice address phone:** (623) 204-6631
- **Mailing address:** 1208 RED BUCKEYE CT, MONCKS CORNER, SC 29461-8600
- **Mailing address phone:** (623) 204-6631

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/23/2026
- **Last updated:** 02/23/2026