| Doctor Name: | BENNIE S HENDERSON |
| NPI Number: | 1043229982 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | F945 |
| Business Practice Address: | 157 B S Greenwood Ave Ext Ware Shoals, SC - 29692 |
| Business Phone Number: | 8644563447 |
| Business Fax Number: | 8647254979 |
| Mailing Address: | 157 B S Greenwood Ave Ext, WARE SHOALS |
| State: | SC |
| Postal Code: | 29692 |
| Phone Number: | 8644563447 |
| Fax Number: | 8647254979 |
| NPI Enumeration Date: | 08/07/2006 |
| NPI Last Update Date: | 04/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | F945 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |