Individual
CHRISTOPHER TODD HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
151 PEACHWOOD CENTRE DR, SPARTANBURG, SC 29301-2575
(864) 562-9627
(864) 560-5470
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
209578
SC
363LF0000X
Family Nurse Practitioner
Primary
19769
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP3439
—
SC
01
—
P01577397
RAILROAD MEDICARE
SC
01
—
SC70245019
MEDICARE PIN
SC
01
—
SC70246067
MEDICARE PIN
SC
01
—
SC70246084
MEDICARE PIN
SC
01
—
SC70246121
MEDICARE PIN
SC
01
—
SC7024J577
MEDICARE PIN
SC
Enumeration date
06/30/2015
Last updated
12/05/2024
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