Provider Demographics
NPI:1871812867
Name:HENDERSON, SHERRYL DENISE (L M)
Entity type:Individual
Prefix:
First Name:SHERRYL
Middle Name:DENISE
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:L M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2865 WOODBURN CT
Mailing Address - Street 2:ATLANTA
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-4738
Mailing Address - Country:US
Mailing Address - Phone:678-791-8368
Mailing Address - Fax:
Practice Address - Street 1:2865 WOODBURN CT
Practice Address - Street 2:ATLANTA
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-4738
Practice Address - Country:US
Practice Address - Phone:678-791-8368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-31
Last Update Date:2010-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay