Provider Demographics
NPI:1649770751
Name:HENSON, DARUS CLYDE (FNP-C)
Entity Type:Individual
Prefix:
First Name:DARUS
Middle Name:CLYDE
Last Name:HENSON
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OLD FORT
Mailing Address - State:NC
Mailing Address - Zip Code:28762-0017
Mailing Address - Country:US
Mailing Address - Phone:828-668-6435
Mailing Address - Fax:833-913-2496
Practice Address - Street 1:32 E MAIN ST
Practice Address - Street 2:
Practice Address - City:OLD FORT
Practice Address - State:NC
Practice Address - Zip Code:28762-0017
Practice Address - Country:US
Practice Address - Phone:828-659-5741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010299363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner