Henderson, Marressa Ruth
Henderson, Marressa Ruth is an individual health care provider with primary practice located at 1101 Professional Blvd , Evansville IN 47714-8016. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Henderson, Marressa Ruth can be contacted via phone (812) 477-7246.Contact Information
Primary practice address
1101 Professional Blvd
Evansville IN 47714-8016
Phone: (812) 477-7246
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 10003026A | Indiana |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 10003026A | Indiana |
Profile Details
| NPI number | 1609487065 |
|---|---|
| LBN Legal business name | Henderson, Marressa Ruth |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 10th, 2020 |
| Last updated | Feb 23rd, 2021 - about 3 years 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 | 1609487065 | NPPES |
| Indiana | MEDICAID | 300043223 | |
| Indiana | MEDICAID | 7100697400 |
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