Provider Demographics
NPI:1013218197
Name:HENDERSON, JOY (PA-C)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 WHEATSHEAF LN
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1177
Mailing Address - Country:US
Mailing Address - Phone:484-213-1890
Mailing Address - Fax:
Practice Address - Street 1:599 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403
Practice Address - Country:US
Practice Address - Phone:484-622-4245
Practice Address - Fax:484-622-2287
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA002578363A00000X
PAMA054719363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant