Provider Demographics
NPI:1699184788
Name:HENDERSON, CARMAN HUNTER (FNP-C)
Entity Type:Individual
Prefix:
First Name:CARMAN
Middle Name:HUNTER
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CARMAN
Other - Middle Name:RAE
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 980663
Mailing Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE - VCU HEALTH SYSTEM
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-0663
Mailing Address - Country:US
Mailing Address - Phone:804-828-9690
Mailing Address - Fax:
Practice Address - Street 1:2116 W LABURNUM AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-4359
Practice Address - Country:US
Practice Address - Phone:804-254-3500
Practice Address - Fax:804-254-1616
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171910363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily