Henderson, Ellena
Henderson, Ellena is an individual health care provider with primary practice located at 1325 Eastmoreland Ave Ste 245 , Memphis TN 38104-3591. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Infectious Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Henderson, Ellena can be contacted via phone (901) 516-9800.Contact Information
Primary practice address
1325 Eastmoreland Ave Ste 245
Memphis TN 38104-3591
Phone: (901) 516-9800
Fax: (901) 516-9817
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 39177 | Tennessee |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 39177 | Tennessee |
Profile Details
| NPI number | 1285689091 |
|---|---|
| LBN Legal business name | Henderson, Ellena |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2006 |
| Last updated | Jan 10th, 2024 - about 10 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285689091 | NPPES |
| Tennessee | Other | P00279007 | RR MEDICARE |
| Tennessee | Other | 4097866 | RR MEDICARE |
| Tennessee | MEDICAID | 3716661 | RR MEDICARE |
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