Individual
JAMES M HENDERSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1-031733
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
RN050883
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051517972
—
AL
01
—
1972568855
TRICARE STANDARD
AL
01
—
1972568855
BC BS OF GA
GA
05
—
842124961A
—
GA
01
—
P00135447
RAILROAD MEDICARE
AL
Enumeration date
04/20/2006
Last updated
03/06/2024
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