Kellie Lawrence Henderson, PA
NPI #1225145865 in East Ridge, Tennessee
Provider Information
- NPI Number
- 1225145865
- Entity Type
- Individual
- Name
- Kellie Lawrence Henderson, PA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant - Medical
- Credential
- PA
- Enumeration Date
- Aug 23, 2006
- Last Updated
- Aug 5, 2015
Practice Location
- Address
- 1508 TOMBRAS AVE
- City
- East Ridge
- State
- Tennessee
- ZIP Code
- 37412-2720
- Phone
- (423) 867-4969
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Medical — Medical |
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