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General NPI Number Information
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NPI Number | 1104829183
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Entity Type | Organization
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Legal Business Name | HENDERSON CLINIC FOR WOMEN PA
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 511 RUIN CREEK RD STE 101
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City | HENDERSON
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State | NC
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Zip | 27536-5919
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Country | US
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Telephone | 252-492-8576
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Fax | 252-492-7464
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Provider Business Mailing Address
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Address Line | 511 RUIN CREEK RD STE 101
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City | HENDERSON
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State | NC
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Zip | 27536-5919
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Country | US
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Telephone | 252-492-8576
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Fax | 252-492-7464
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. NANCY P KING
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Credential |
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Telephone | 252-492-8576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 39877
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License Number State | NC
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