Individual
STEPHEN S. HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(855) 446-5937
(740) 441-8058
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5238
(740) 441-8058
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
59476
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
COA.09873NA
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000230049
OH MEDICAID UNISON
OH
01
—
000000307864
ANTHEM BCBS
—
05
—
1104845924
—
WV
05
—
2298731
—
OH
01
—
500022235
RR MEDICARE
—
Enumeration date
07/19/2006
Last updated
01/21/2021
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