STACEY HENDERSON

SHREVEPORT, LA
NPI1649666405
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207P00000X Emergency Medicine
(Licence: LA  308050)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2015-04-08
Last Update Date2018-05-14
Business Address
STACEY HENDERSON MD
2510 BERT KOUN LOOP
SHREVEPORT, LA 71118-3119
Phone number: 318-212-4000
Mailing Address
STACEY HENDERSON MD
939 HIGHWAY 171
STONEWALL, LA 71078-9595
Phone number: 318-925-8825
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