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General NPI Number Information
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NPI Number | 1336142959
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Entity Type | Individual
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Provider Name | NANCY HENDERSON-HINES M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 6387 RAMSEY ST SUITE 210
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City | FAYETTEVILLE
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State | NC
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Zip | 28311-9420
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Country | US
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Telephone | 910-609-3920
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Fax | 910-321-6221
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Provider Business Mailing Address
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Address Line | PO BOX 40908
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City | FAYETTEVILLE
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State | NC
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Zip | 28309-0908
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Country | US
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Telephone | 910-609-6448
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Fax | 910-609-7040
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 36731
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License Number State | NC
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