Provider Demographics
NPI:1437561750
Name:MCHENRY, JENNIFER DAWN (FNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DAWN
Last Name:MCHENRY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 POINT NORTH PL
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-2644
Mailing Address - Country:US
Mailing Address - Phone:706-272-4127
Mailing Address - Fax:706-279-3969
Practice Address - Street 1:1940 WESTLAND DR SW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-8102
Practice Address - Country:US
Practice Address - Phone:423-813-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN161794163W00000X
GARN280678363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse