Individual
MRS. CARISSA HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
832 W POPLAR AVE, COLLIERVILLE, TN 38017-4047
(901) 853-6428
Mailing address
832 W POPLAR AVE, COLLIERVILLE, TN 38017-4047
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22475
TN
Other
Enumeration date
04/02/2017
Last updated
04/02/2017
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