Individual
MARRESSA RUTH HENDERSON
Active
Individual
MARRESSA RUTH HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
10003026A
IN
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
10003026A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300043223
—
IN
05
—
7100697400
—
KY
Enumeration date
08/10/2020
Last updated
02/23/2021
Update your record
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