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General NPI Number Information
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NPI Number | 1528057171
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Entity Type | Individual
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Provider Name | CHERYL HENSON PA
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Gender | Female
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 1621 HIGHWAY 17 N
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City | NORTH MYRTLE BEACH
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State | SC
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Zip | 29582-2229
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Country | US
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Telephone | 843-353-3460
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Fax | 843-353-3461
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Provider Business Mailing Address
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Address Line | PO BOX 602811
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City | CHARLOTTE
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State | NC
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Zip | 28260-2811
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Country | US
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Telephone | 828-213-1500
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Fax | 828-651-6570
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-06674
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0010-06674
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 0010-06674
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4691
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License Number State | SC
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