Henson, Wanda Faye
Henson, Wanda Faye is an individual health care provider with primary practice located at 12207 Highway 49 Suite 40, Gulfport MS 39503-2955. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Henson, Wanda Faye can be contacted via phone (228) 388-3312.Contact Information
Primary practice address
12207 Highway 49 Suite 40
Gulfport MS 39503-2955
Phone: (228) 388-3312
Fax: (228) 388-3313
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R518328 | Mississippi |
Profile Details
| NPI number | 1538144589 |
|---|---|
| LBN Legal business name | Henson, Wanda Faye |
| Credentials | FNP-BC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 13th, 2005 |
| Last updated | Jun 6th, 2014 - about 10 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 | 1538144589 | NPPES |
| Mississippi | MEDICAID | 06954562 |
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