Individual
CHERYL HENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1621 HIGHWAY 17 N, NORTH MYRTLE BEACH, SC 29582-2229
(843) 353-3460
(843) 353-3461
Mailing address
PO BOX 602811, CHARLOTTE, NC 28260-2811
(828) 213-1500
(828) 651-6570
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-06674
NC
363A00000X
Physician Assistant
Primary
4691
SC
363AM0700X
Medical Physician Assistant
0010-06674
NC
363AS0400X
Surgical Physician Assistant
0010-06674
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6004PA
—
SC
Enumeration date
10/17/2005
Last updated
05/24/2023
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