National Provider Identifier Database

JESSICA HENDERSON, NP-C – NPI #1790194314
Family


Contact Information

JESSICA HENDERSON, NP-C
2300 MANCHESTER EXPY
STE 2001
COLUMBUS, GA31904-6877
Phone: 706-323-5552
Fax: 706-324-5695
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for JESSICA HENDERSON

NPI Number 1790194314
Credentials NP-C (Nurse Practitioner - Certified)
Entity Individual
Enumeration date 08/07/2014
Last updated 10/13/2015 - About 11 years ago
Sole proprietor1 No
Identifiers
  • AL License #: 1-129486
  • GA License #: RN246307
  • AL Medicaid: 174933
  • GA Medicaid: 003163038A
Hospital affiliation n/a

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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