MARISSA LYNNE HENDERSON (NPI# 1518502475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518502475 |
| Entity Type | Individual |
| Full Name | MARISSA LYNNE HENDERSON |
| Credential | MSN, APRN, FNP-C |
| Practice Address |
609 Medical Center Dr Ste 2700 Decatur TX 76234-3839 |
| Mailing Address |
Po Box 1000 Decatur TX 76234-6000 |
| Practice Telephone | 9406278020 |
| Practice Fax Number | 9406276730 |
| Mailing Telephone | 9406278020 |
| Mailing Fax Number | 9406276730 |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2019-11-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | AP143723 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | PENDING | 01 |
| TX | PENDING | 05 |
| Street Address |
609 MEDICAL CENTER DR STE 2700 |
| City | DECATUR |
| State | TX |
| Zip Code | 76234-3839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477102028 | Ursula Eileen Fernandez-plata | Technician | 1221 Cr 4371, Decatur, TX 76234 | 2019-09-06 |
| 1649772377 | Stephanie Jennie Roddenberry | Nurse Practitioner | 2301 S Fm 51 Ste 500, Decatur, TX 76234 | 2018-03-08 |
| 1467731679 | David Gatti Corless | Dentist | 301 W. Main St., Decatur, TX 76234 | 2011-08-05 |
| 1376830067 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 805 W Business Hwy 380, Decatur, TX 76234 | 2011-07-01 |
| 1356667844 | Richard Ryan Ooten | Specialist/Technologist, Other | 239 Harvey Lane, Decatur, TX 76234 | 2010-04-09 |
| 1003049032 | Advanced Gastroenterology Associates, Pa | Internal Medicine | 607 Medical Center Drive, Suite 2600, Decatur, TX 76234 | 2009-08-25 |
| 1831346188 | Rufus John Nelson | Dentist | 1710 S Hwy 51 Ste 20,pmb #176, 1000 W Business Hwy 380, Decatur, TX 76234 | 2008-08-19 |
| 1851558449 | James Lee Hendrick | Counselor | 2304 Fm 51 South, Decatur, TX 76234 | 2008-05-21 |
| 1891964995 | Sheryl A White | Counselor | 1106 E Business Hwy 380, Decatur, TX 76234 | 2008-02-22 |
| 1366625022 | Tower Mutual Holding Company, Inc. | Durable Medical Equipment & Medical Supplies | 206 N. State Street, Decatur, TX 76234 | 2007-12-17 |
| Find all providers in zip 76234 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427686062 | Tara Cooley | Nurse Practitioner | 909 Tracey Ln, Decatur, AL 35601-7701 | 2020-03-30 |
| 1407489479 | Marathon Health LLC | Nurse Practitioner | 152 Ipsco St, Decatur, AL 35601-7412 | 2020-02-19 |
| 1912463456 | Kimberly S Williams | Nurse Practitioner | 4565 Riverwood Cir, Decatur, GA 30035-2935 | 2019-02-20 |
| 1164907242 | Megan Skelley | Nurse Practitioner | 487 Winn Way Ste 202, Decatur, GA 30030-1728 | 2018-09-25 |
| 1508359969 | Rebecca A Voyles | Nurse Practitioner | 575 W Hay St, Decatur, IL 62526-4164 | 2018-06-11 |
| 1598278558 | Vera Mahou | Nurse Practitioner | 4150 Snapfinger Woods Dr Ste 120, Decatur, GA 30035-3417 | 2017-11-13 |
| 1346753738 | Alexis Renee Graven | Nurse Practitioner | 2300 N Edward St Ste 2400, Decatur, IL 62526-4163 | 2017-11-08 |
| 1508240409 | Zachary Pitts | Nurse Practitioner | 2606 Woodridge Dr, Decatur, GA 30033-4835 | 2015-07-10 |
| 1891063095 | Alexis E. Daugherty | Nurse Practitioner | 603 Church St, Decatur, GA 30030-2517 | 2011-12-02 |
| 1235392689 | David Gerardo Barraza | Nurse Practitioner | 2422 Donville Road, Suite E, Decatur, AL 35603 | 2008-07-07 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.