Provider Demographics
NPI:1952629180
Name:HENDERSON-LEE, MARGARET (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:HENDERSON-LEE
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 1:2189 WEST ST STE 2
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3884
Mailing Address - Country:US
Mailing Address - Phone:901-496-0167
Mailing Address - Fax:901-421-5967
Practice Address - Street 1:2189 WEST ST STE 2
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3884
Practice Address - Country:US
Practice Address - Phone:901-496-0167
Practice Address - Fax:901-421-5967
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106888163W00000X
TN14980363LF0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No163W00000XNursing Service ProvidersRegistered Nurse
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily