| Doctor Name: | DR. MELINDA C. HENDERSON |
| NPI Number: | 1487771945 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP, FAAN, |
| License Number: | 383902 |
| Business Practice Address: | 4413 Us Highway 331 S Defuniak Springs, FL - 324356307 |
| Business Phone Number: | 8509514500 |
| Business Fax Number: | |
| Mailing Address: | 504 Circle Dr, DEFUNIAK SPRINGS |
| State: | FL |
| Postal Code: | 324352565 |
| Phone Number: | 8508925610 |
| Fax Number: | 8508927254 |
| NPI Enumeration Date: | 03/22/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 383902 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |