Individual
STEVAN KAI HENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1060 E COUNTY LINE RD STE 6, RIDGELAND, MS 39157-1937
(601) 438-2678
Mailing address
1060 E COUNTY LINE RD STE 6, RIDGELAND, MS 39157-1937
(601) 438-2678
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00520
MS
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
08/12/2019
Last updated
07/19/2022
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