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General NPI Number Information
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NPI Number | 1831248335
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Entity Type | Individual
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Provider Name | MS. SHARON HENDERSON
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3800 HILLSBOROUGH ST CARROLL HEALTH CENTER
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City | RALEIGH
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State | NC
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Zip | 27607-5237
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Country | US
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Telephone | 919-760-8139
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Fax | 919-760-8534
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Provider Business Mailing Address
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Address Line | 8701 OLD TOM WAY
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City | RALEIGH
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State | NC
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Zip | 27613-5433
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Country | US
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Telephone |
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Fax |
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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 | 101540
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License Number State | NC
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