Jacqueline Henderson
Nurse Practitioner, Psych/Mental Health in Jacksonville, FL. Individual provider (NPI-1).
NPI number1366851925
StatusActive
Last updated in NPPESNov 1, 2026
Details
- NPI
- 1366851925
- Entity type
- Individual (NPI-1)
- Name
- Jacqueline Henderson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 7, 2014
- Certification date
- Nov 1, 2026
- Last updated
- Nov 1, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | APRN11050975 | FL | Yes |
| 163W00000X | Registered Nurse | 9439791 | FL |
Practice location
10175 Fortune Pkwy Unit 903Jacksonville, FL 32256-6755
Phone 904-503-3579
Mailing address
10175 Fortune Pkwy Unit 903Jacksonville, FL 32256-6755
Phone 904-535-3623
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