Healthcare Provider Details

I. General information

NPI: 1043987431
Provider Name (Legal Business Name): SCHERRICA HOLLI HENDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 BERTHA RD STE B
TAOS NM
87571-7148
US

IV. Provider business mailing address

801 TRAVIS ST
HOUSTON TX
77002-5719
US

V. Phone/Fax

Practice location:
  • Phone: 575-758-4297
  • Fax: 575-999-9630
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95228278
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1153463
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: