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Contact Information

TYKERRIA R HENDERSON
30 PINEHURST ST
PORT GIBSON, MS39150-2850
 Phone: 931-278-9365
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for TYKERRIA R HENDERSON · (Female)

NPI Number 1104775865
Status Active
Credentials
Entity Individual
Enumeration date 01/26/2026
Last updated 01/26/2026 - About 4 months ago
Sole proprietor 1 No
Identifiers
  • MS License # 922851
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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