Individual
DR. KENYA HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2600 MCINGVALE RD, HERNANDO, MS 38632-8658
(662) 429-7099
(662) 449-3021
Mailing address
2600 MCINGVALE RD, HERNANDO, MS 38632-8658
(662) 429-7099
(662) 449-3021
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2618
TN
152W00000X
Optometrist
Primary
741
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02450266
—
MS
Enumeration date
02/16/2007
Last updated
10/02/2023
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