Individual
MRS. JERMISSIA LATRICE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNPC-AG
Contact information
Practice address
2600 GREENWOOD RD, SHREVEPORT, LA 71103-3908
(318) 212-4000
Mailing address
222 CESSNA DR, SHREVEPORT, LA 71106-3421
(318) 212-4000
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
220444
LA
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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