Individual
MR. JOHN P HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1001 SAM PERRY BLVD, FREDERICKSBURG, VA 22401-4453
(540) 741-7614
Mailing address
3100 SPRING FOREST RD STE 130, RALEIGH, NC 27616-2880
(888) 280-9533
(919) 873-9821
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
CRNA-0024164722
VA
207L00000X
Anesthesiology Physician
RN-0001152041
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056843700
—
DC
05
—
1629077193
—
VA
Enumeration date
07/18/2005
Last updated
03/17/2018
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