Individual
JENNIFER HENLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 362-5321
Mailing address
PO BOX 3437, JACKSON, MS 39207-3437
(601) 362-5321
(601) 364-5159
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
AP140103
TX
363LF0000X
Family Nurse Practitioner
Primary
903852
MS
Other
Enumeration date
01/16/2019
Last updated
05/05/2020
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