Individual provider · Type 1 NPI
Tanisha M. Henry, PA
Medical Physician Assistant · Jacksonville, FL
NPI number
1003879735
Active
Practice location
4500 San Pablo Rd S, Vincent Stabile Bldg 550N
Jacksonville, FL 32224-1865
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0110010456 (VA) |
| Medical Physician Assistant | 363AM0700X | 029626 (NY) |
| Medical Physician Assistant | 363AM0700X | PA62280 (CA) |
| Medical Physician Assistant | 363AM0700X | 724323 (WI) |
| Medical Physician Assistant | 363AM0700X | AMD1403 (HI) |
| Medical Physician Assistant | 363AM0700X | 085009476 (IL) |
| Medical Physician Assistant Primary | 363AM0700X | PA9103457 (FL) |
Medical Physician Assistant: Definition to come...
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About NPI 1003879735
Tanisha M. Henry, PA's National Provider Identifier is 1003879735, issued on Apr 12, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Jacksonville, FL. The record was last updated on Dec 18, 2024.