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NPI Code Detail

MEDICARE: JAUSHAI HENRY

MEDICARE: JAUSHAI HENRY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerR237760MD
2163W00000XRegistered NurseR237760MD

General Provider Information

NPI Number : 1386333987
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAUSHAI HENRY
Provider Business Mailing Address
First Line : 255 E PACES FERRY RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30305-2233
Country : US
Telephone Number : 301-335-7960
Fax Number :
Provider Business Practice Location Address
First Line : 255 E PACES FERRY RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30305-2233
Country : US
Telephone Number : 301-335-7960
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2023
Last Update Date : 12/01/2025

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