Individual
SAMANTHA HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
104 KAYSE CT, WOODSTOCK, GA 30188-2320
(404) 401-7971
Mailing address
104 KAYSE CT, WOODSTOCK, GA 30188-2320
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
283588
GA
Other
Enumeration date
07/31/2024
Last updated
10/21/2025
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