Organization
HENDERSON FAMILY PRACTICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI TAYMAN HENDERSON NP-C (FAMILY NURSE PRACTITIONER/OWNER)
(912) 809-6052
Entity
Organization
Contact information
Practice address
624 TEBEAU ST, WAYCROSS, GA 31501-4728
(912) 809-6052
(912) 809-6070
Mailing address
403 LISTER ST, SUITE A, WAYCROSS, GA 31501-5225
(912) 283-4422
(912) 283-4866
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
RN133742
GA
Other
Enumeration date
08/15/2016
Last updated
10/31/2024
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