Individual
AMBER LYNNE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2095 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-5733
(843) 402-1436
(843) 402-1833
Mailing address
PO BOX 632509, CINCINNATI, OH 45263-2508
(803) 765-1838
(803) 765-1732
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
21151
SC
367500000X
Certified Registered Nurse Anesthetist
52671
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2602523000
—
WV
05
—
AN2706
—
SC
Enumeration date
08/23/2006
Last updated
06/29/2026
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