| Doctor Name: | DR. MARGO LOUISE HENDERSON |
| NPI Number: | 1023229887 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 078420 |
| Business Practice Address: | 465 N Belair Rd Ste 2b Evans, GA - 308093190 |
| Business Phone Number: | 7067747400 |
| Business Fax Number: | 7067747590 |
| Mailing Address: | Po Box 1705, AUGUSTA |
| State: | GA |
| Postal Code: | 309031705 |
| Phone Number: | 7068546917 |
| Fax Number: | 7067747230 |
| NPI Enumeration Date: | 05/24/2007 |
| NPI Last Update Date: | 01/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 078420 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |