Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 7696 | GA |
N | 111NI0900X | Internist | 7696 | GA |
Y | 207RH0002X | Hospice and Palliative Medicine | 85289 | GA |
NPI | 1114306446 |
---|---|
Provider Name | Audrey Henson |
First Address | Macon, GA 31201-2102 |
Second Address | Macon, GA 31201-2102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2015 |
Last Update Date | 19/08/2020 |