| Doctor Name: | SUSAN MARIE HENDERSON |
| NPI Number: | 1184753063 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | MA002063L |
| Business Practice Address: | 595 W Carolina Ave Varnville, SC - 299444735 |
| Business Phone Number: | 8039437612 |
| Business Fax Number: | |
| Mailing Address: | 45 Jarvis Creek Ln, HILTON HEAD ISLAND |
| State: | SC |
| Postal Code: | 299264415 |
| Phone Number: | 4124438402 |
| Fax Number: | |
| NPI Enumeration Date: | 03/05/2007 |
| NPI Last Update Date: | 03/07/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | MA002063L |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |