Caron C Henderson (NPI# 1316253115, PAC ID# 2466612825) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1316253115 |
| PAC ID by PECOS | 2466612825 |
| Professional Enrollment ID | I20120322000576 |
| Full Name | Caron C Henderson |
| Organization Legal Name | WCS PROFESSIONAL SERVICES OF MISSISSIPPI, LLC |
| Address |
1065 E Broad St Lawrence Cnty Hosp Monticello MS 39654-7703 |
| Phone Number | 6015874051 |
| Gender | F |
| Graduation Year | 2010 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 3476790502 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250078 | FORREST GENERAL HOSPITAL |
| 251305 | LAWRENCE COUNTY HOSPITAL CAH |
| Address | Phone | Organization |
|---|---|---|
| 6051 U S Hwy 49, Hattiesburg, MS 39401-7200 | 6012882690 | FGH TRAUMA SURGERY CLINIC |
| 1065 E Broad St, Lawrence Cnty Hosp, Monticello, MS 39654-7703 | 6015874051 | WCS PROFESSIONAL SERVICES OF MISSISSIPPI, LLC |
| Organization Legal Name | WCS PROFESSIONAL SERVICES OF MISSISSIPPI, LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sharon Cranford Easterling | Nurse Practitioner | Wcs Professional Services of Mississippi, LLC | 701 S Holly Ave, Collins, MS 39428-3894 |
| Street Address |
1065 E BROAD ST LAWRENCE CNTY HOSP |
| City | MONTICELLO |
| State | MS |
| Zip | 39654-7703 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Larry K Cruel | Podiatry | River Health Care LLC | 157 F E Sellers Hwy, Monticello, MS 39654 |
| Brantley Bernard Pace | General Practice | 713 Watts St, Monticello, MS 39654-0518 | |
| Deontranese T Taylor | Nurse Practitioner | 314 Main St, Suite D, Monticello, MS 39654-3702 | |
| Greta L Keys | Nurse Practitioner | 1132 E Broad St, Monticello, MS 39654-7681 | |
| Patrick B Wood | Family Medicine | Southwest Mississippi Regional Medical Center | 1167 E Broad St, Monticello, MS 39654-7682 |
| Teresa Q Conerly | Nurse Practitioner | Family Health Care Clinic Inc | 430 W Broad St, Monticello, MS 39654-7723 |
| Rebecca Hussey Burris | Nurse Practitioner | 827 F E Sellers Hwy, Burris Medical Clinic, Monticello, MS 39654-9378 | |
| Richard G Burris | Family Medicine | 827 F E Sellers Hwy, Monticello, MS 39654-9378 |
| City | MONTICELLO |
| Zip Code | 39654 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | MONTICELLO + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Caron C Henderson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.