MARY ANN HENDERSON (NPI# 1699326843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699326843 |
| Entity Type | Individual |
| Full Name | MARY ANN HENDERSON |
| Practice Address |
339 Mason Blvd Jackson MS 39212-5151 |
| Mailing Address |
2811 Ridgeland Dr Jackson MS 39212-2516 |
| Practice Telephone | 6019414311 |
| Mailing Telephone | 6019414311 |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2019-09-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747A0650X |
Technician Specialization: Attendant Care Provider |
Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801379599 | Mary Pullias Henderson | Nurse Practitioner | 2788 Murfreesboro Road, Antioch, TN 37013-2004 | 2018-09-10 |
| 1063935773 | Mary Kathryn Henderson | Speech-Language Pathologist | 1400 Griffin Mill Road, Easley, SC 29640 | 2017-07-25 |
| 1467832485 | Mary Ellen Henderson | Registered Nurse | 1038 Davis Rd, West Falls, NY 14170-9781 | 2015-06-04 |
| 1003305798 | Mary Henderson | Community Health Worker | 104 S Front Ave, Prestonsburg, KY 41653-1614 | 2018-05-08 |
| 1225547508 | Mary Kathleen Henderson | Counselor | 393 Main St, Danville, NH 03819-3219 | 2017-09-29 |
| 1285181776 | Mary May Henderson | Nurse Practitioner | 10701 W Research Dr, Wauwatosa, WI 53226-3452 | 2016-09-01 |
| 1538517149 | Mary Henderson | Case Manager/Care Coordinator | 25 Gap Rd, Batesville, AR 72501-8679 | 2016-05-25 |
| 1548616535 | Mary K Henderson | Social Worker | 4400 Euclid Ave, Cleveland, OH 44103-3734 | 2016-05-09 |
| 1013391762 | Mary Henderson | Nurse Practitioner | 447 Mcalister Rd, Ste 2400, Lincolnton, NC 28092-4114 | 2015-07-13 |
| 1245578202 | Mary Nicole Henderson | Dietitian, Registered | 747 52nd St, Oakland, CA 94609-1809 | 2013-01-26 |
| Street Address |
339 MASON BLVD |
| City | JACKSON |
| State | MS |
| Zip Code | 39212-5151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013406172 | South Central Community Action Agency, Inc | Non-emergency Medical Transport (VAN) | 3891 I-55 South Frontage Rd, Jackson, MS 39212 | 2018-05-04 |
| 1508305780 | Caring Companions LLC | Home Health | 1024 Cooper Rd, Jackson, MS 39212 | 2017-02-21 |
| 1750634044 | Christians In Action, Inc. | Community/Behavioral Health | 2025 North Siwell Rd, Jackson, MS 39212 | 2012-10-24 |
| 1609164748 | Counseling and Mentoring Program | Community/Behavioral Health | 2964 Terry Road B-1, Jackson, MS 39212 | 2011-07-11 |
| 1407179039 | Caring Hands Community Services Inc | Skilled Nursing Facility | 3318 Longwood Drive, Jackson, MS 39212 | 2010-03-10 |
| 1992239404 | Shaemik Harris | Registered Nurse | 3520 Sykes Park Dr, Jackson, MS 39212 | 2017-04-12 |
| 1780044438 | Alfonzo Haralson | Counselor | 132 Thousand Oaks Cir, Jackson, MS 39212-2046 | 2016-02-24 |
| 1659384063 | Kentrell Marie Liddell | Family Medicine | 2104 Thousand Oaks Dr, Jackson, MS 39212-2048 | 2006-08-15 |
| 1649819590 | George Cavett Jr. | Nurse Practitioner | 2450 Twisted Oak Dr, Jackson, MS 39212-2137 | 2019-12-24 |
| 1912455361 | Victorious Healthcare L.L.C. | Assisted Living Facility | 4959 Laurel Oak Dr, Jackson, MS 39212-2150 | 2016-09-14 |
| Find all providers in zip 39212 | ||||
| Taxonomy Code | 3747A0650X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Attendant Care Provider |
| An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316559966 | Royeisha Deshawn Walker | Technician | 3635 Hancock St, Jackson, MS 39213-5803 | 2020-08-17 |
| 1407495245 | Tiffany Marie Griffin | Technician | 1980 Highway 80 W, Jackson, MS 39204-2303 | 2019-12-26 |
| 1881230084 | Warren Johnson | Technician | 1932 Linda Ln, Jackson, MS 39213-4447 | 2019-11-22 |
| 1679117980 | Cynthia Bailey | Technician | 916 Carnation Street, Jackson, MS 39213 | 2019-10-30 |
| 1871136374 | Shirley Collins Williams | Technician | 3132 Sage St, Jackson, MS 39213 | 2019-10-28 |
| 1750923959 | Patricia Ann Benjamino | Technician | 8 Poplar Street, Jackson, NJ 08527 | 2019-10-09 |
| 1043852155 | Laquinta Cavett | Technician | 3740 John F Kennedy Blvd, Jackson, MS 39213-2919 | 2019-10-09 |
| 1154970978 | Jasmine Lindsey | Technician | 4001 Rainey Rd, Jackson, MS 39212-5325 | 2019-09-04 |
| 1255776993 | Gareth Gene Walker | Technician | 514 Covinton Street, Jackson, GA 30233 | 2013-05-08 |
| 1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
| Find all providers in JACKSON | ||||
Please comment or provide details below to improve the information on MARY ANN HENDERSON.
| 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.