Individual
MRS. JESSICA HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2300 MANCHESTER EXPY, STE 2001, COLUMBUS, GA 31904-6877
(706) 323-5552
(706) 324-5695
Mailing address
PO BOX 9006, COLUMBUS, GA 31908-9006
(706) 323-5552
(706) 324-5695
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1-129486
AL
363LF0000X
Family Nurse Practitioner
Primary
RN246307
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003163038A
—
GA
05
—
174933
—
AL
Enumeration date
08/07/2014
Last updated
10/13/2015
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