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General NPI Number Information
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NPI Number | 1639717713
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Entity Type | Individual
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Provider Name | CRAIG DAMON HENRY MSN, APRN, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 12/19/2019
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Last Update Date | 12/19/2019
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Provider Practice Location Address
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Address Line | 1824 HOSPITAL DR
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City | JACKSON
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State | MS
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Zip | 39204-3410
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Country | US
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Telephone | 601-346-4586
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Fax | 601-346-4587
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Provider Business Mailing Address
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Address Line | 837 CRESTON DR
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City | BYRAM
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State | MS
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Zip | 39272-3003
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Country | US
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Telephone | 601-613-5681
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Fax | 601-372-3059
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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 | 163WC1600X
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Taxonomy Name | Continuing Education/Staff Development Registered Nurse
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License Number | 903338
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 163WH1000X
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Taxonomy Name | Hospice Registered Nurse
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License Number | 903338
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | 903338
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 163WN1003X
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Taxonomy Name | Nutrition Support Registered Nurse
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License Number | 903338
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 903338
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License Number State | MS
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Taxonomy #6
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Taxonomy Code | 163WX0200X
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Taxonomy Name | Oncology Registered Nurse
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License Number | 903338
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License Number State | MS
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Taxonomy #7
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 903338
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License Number State | MS
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Taxonomy #8
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 903338
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License Number State | MS
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Taxonomy #9
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 903338
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License Number State | MS
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Taxonomy #10
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 903338
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License Number State | MS
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Taxonomy #11
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 903338
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License Number State | MS
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