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Individual

MRS. RUBY LARNA HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
550 PEACHTREE STREET NE, SUITE 1275, ATLANTA, GA 30308
(404) 872-3121
(404) 872-3119
Mailing address
550 PEACHTREE ST NE STE 1275, ATLANTA, GA 30308-2240
(404) 872-3121
(404) 872-3119

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
RN098527
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000701489
GA
Enumeration date
11/07/2005
Last updated
09/30/2021
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