Individual
MR. HUNTER B HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1900 EXETER RD, SUITE 210, GERMANTOWN, TN 38138-2954
(901) 818-2183
(901) 682-9522
Mailing address
1900 EXETER RD, SUITE 210, GERMANTOWN, TN 38138-2954
(601) 529-9903
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R871673
MS
367500000X
Certified Registered Nurse Anesthetist
Primary
16751
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04534393
—
MS
05
—
1530030
—
TN
05
—
194804001
—
AR
01
—
1962768879
CHAMPUS/TRICARE
—
01
—
4333549
BCBST
TN
01
—
P01117345
RAILROAD MEDICARE
—
Enumeration date
04/04/2012
Last updated
04/10/2013
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