Provider Demographics
NPI:1790444875
Name:HENDERSON, SAYLEM MAY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SAYLEM
Middle Name:MAY
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8648 NORTHRIDGE LOOP
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-7516
Mailing Address - Country:US
Mailing Address - Phone:978-223-5364
Mailing Address - Fax:
Practice Address - Street 1:8648 NORTHRIDGE LOOP
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-7516
Practice Address - Country:US
Practice Address - Phone:978-223-5364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-15
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM73714207R00000X, 363LF0000X
FL11017032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine