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Organization

HENSON MEDICAL CLINIC, INC.

Active
Other names
Urgent Care -- Long Beach
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. WANDA F. HENSON FNP-BC (EXECUTIVE DIRECTOR)
(228) 864-0622
Entity
Organization

Contact information

Practice address
200 W RAILROAD ST, 104, LONG BEACH, MS 39560-4517
(228) 864-0622
(228) 864-7958
Mailing address
PO BOX 609, LONG BEACH, MS 39560-0609
(228) 864-0622
(228) 864-7958

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R518328
MS
363LF0000X
Family Nurse Practitioner
R862256
MS

Other

Enumeration date
05/06/2009
Last updated
05/06/2009
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