Healthcare Provider Details

I. General information

NPI: 1942043294
Provider Name (Legal Business Name): MARTHA JEAN HENDERSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2024
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3143 SW 32ND AVE STE 200
OCALA FL
34474-4404
US

IV. Provider business mailing address

2633 SE 28TH ST
OCALA FL
34471-6273
US

V. Phone/Fax

Practice location:
  • Phone: 352-282-0010
  • Fax: 352-496-3245
Mailing address:
  • Phone: 352-895-0778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11032964
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: