Individual
DEIDRA DIANE HENLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
410 UNIVERSITY PKWY STE 1550, AIKEN, SC 29801-6838
(803) 649-7535
(803) 648-8771
Mailing address
2946 AYLESBURY DR, AUGUSTA, GA 30909-0628
(803) 640-8094
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN205120
GA
Other
Enumeration date
10/08/2018
Last updated
07/11/2024
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