Individual provider · NPI-1
Erica Deon Henry, RN
Registered Nurse · Loganville, GA
NPI number1457043705
StatusActive
Last updated in NPPESMay 24, 2023
Details
- NPI
- 1457043705
- Entity type
- Individual (NPI-1)
- Name
- Erica Deon Henry
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 24, 2023
- Certification date
- May 24, 2023
- Last updated
- May 24, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | RN292512 | GA | Yes |
| 251S00000X | Community/Behavioral Health | – | – |
Practice location
411 Levon CtLoganville, GA 30052-3791
Phone 267-760-3681
Mailing address
411 Levon CtLoganville, GA 30052-3791
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