BETH HARRIS HENDERSON (NPI# 1124627930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124627930 |
| Entity Type | Individual |
| Full Name | BETH HARRIS HENDERSON |
| Credential | APRN |
| Practice Address |
4784 W Us Highway 90 Lake City FL 32055-3101 |
| Mailing Address |
23343 Nw County Road 236 High Springs FL 32643-9669 |
| Practice Telephone | 3862699260 |
| Practice Fax Number | 3864066714 |
| Mailing Telephone | 3864540698 |
| Mailing Fax Number | 3864540690 |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2020-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN11008627 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871684274 | Beth A. Henderson | Optometrist | 7840 Natural Bridge Rd, Patient Care Center, Saint Louis, MO 63121-4617 | 2006-09-28 |
| Street Address |
4784 W US HIGHWAY 90 |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32055-3101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467814582 | Osayamen O Omoruyi | Family Medicine | 4784 W Us Highway 90, Lake City, FL 32055-3101 | 2016-03-28 |
| 1972140358 | Trenton Medical Center, Inc | Clinic/Center | 4784 W Us Highway 90, Lake City, FL 32055-3101 | 2019-12-05 |
| 1679122337 | Trenton Medical Center, Inc. | Pharmacy | 4784 W Us Highway 90, Lake City, FL 32055-3101 | 2019-09-05 |
| 1811436751 | Jana Ruth Underhill | Nurse Practitioner | 4784 W Us Highway 90, Lake City, FL 32055-3101 | 2017-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114439510 | Melissa Fay Peters | Nurse Practitioner | 5085 West Us Highway 90, Lake City, FL 32055 | 2017-10-26 |
| 1851801765 | Stephanie Jo Nogle | Occupational Therapist | Brooks Americare: 4251 Nw American Ln, #103, Lake City, FL 32055 | 2017-10-05 |
| 1831617273 | Erica Mayo | Pharmacist | 4846 Nw Lake Jeffery Rd., Lake City, FL 32055 | 2017-09-06 |
| 1144759333 | Jerry Hamilton Cheesman | Dentist | 217 Ne Franklin Sreet, Lake City, FL 32055 | 2017-06-09 |
| 1487183745 | Joshua Allore | Dentist | 2970 W Us Highway 90., Lake City, FL 32055 | 2017-06-08 |
| 1497298418 | Careing Hands | Preferred Provider Organization | 1471nw Queen Rd, Lakecity, FL 32055 | 2016-11-22 |
| 1881148278 | Corniqueca Stewart-simmons | Nurse Practitioner | 340 Nw Commerce Drive, Lake City, FL 32055 | 2016-08-15 |
| 1164809141 | Latasha Harten-jones | Licensed Practical Nurse | 443 Ne Sims Dr, Lake City, FL 32055 | 2015-04-29 |
| 1154716447 | Lindsey Morton | Counselor | 219 Se Baya Avenue, Lake City, FL 32055 | 2015-04-02 |
| 1124439351 | Tynette Jordan | Counselor | 708 N.w Wilson St., Lake City, FL 32055 | 2014-05-09 |
| Find all providers in zip 32055 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376151530 | Anne M Egan | Nurse Practitioner | 1608 N Oak St, Lake City, MN 55041-9031 | 2020-07-14 |
| 1104462225 | Markie Hunter | Nurse Practitioner | 236 Sw Birch Gln, Lake City, FL 32024-0795 | 2019-11-24 |
| 1255983854 | Carlon Darneil Jenkins | Nurse Practitioner | 126 Williamsburg Ave, Lake City, SC 29560-2734 | 2019-07-13 |
| 1811477078 | Jordan Budwick | Nurse Practitioner | 2970 W Us Highway 90 Ste 120, Lake City, FL 32055-4703 | 2018-08-17 |
| 1508343526 | Ashton Cagle Godwin | Nurse Practitioner | 1236 Mccutcheon Rd, Lake City, SC 29560-5619 | 2018-07-23 |
| 1811411754 | David Charles Terrell Jr. | Nurse Practitioner | 410 Sw Silver Palm Dr, Lake City, FL 32024-6757 | 2017-08-02 |
| 1164811576 | Sharma Atkinson-staten | Nurse Practitioner | 619 Sw Baya Dr Ste 102, Lake City, FL 32025-4204 | 2015-01-22 |
| 1750587002 | Jennifer Haith Scott | Nurse Practitioner | 221 Sw Stonegate Ter, Suite 101, Lake City, FL 32024-3463 | 2007-06-25 |
| 1902008857 | Laura Ann Parks | Nurse Practitioner | 4241 Nw American Ln, Lake City, FL 32055-4881 | 2007-06-04 |
| 1760693022 | Stephanie Kate Finnell | Nurse Practitioner | 351 Nw Franklin St, Suite 2, Lake City, FL 32055 | 2007-05-25 |
| Find all providers in LAKE CITY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.