Individual
SHERRI LEANN HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
240 N WICKHAM RD STE 108, MELBOURNE, FL 32935-8663
(321) 841-1777
(321) 841-1788
Mailing address
240 N WICKHAM RD STE 108, MELBOURNE, FL 32935-8663
(321) 541-1777
(321) 541-1788
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9105795
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9105795
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106506700
—
FL
05
—
200066220A
—
OK
Enumeration date
02/28/2006
Last updated
03/31/2025
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