Provider Demographics
NPI:1679186407
Name:HENRIKSON, SHARON D (NP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:D
Last Name:HENRIKSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:012-005-6786
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:205A BELLE MEADE PT
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-3311
Practice Address - Country:US
Practice Address - Phone:601-200-5678
Practice Address - Fax:601-992-0096
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS903993363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner