Active NPI
Candace Yvette Henderson, PHARM. D.
- Pharmacist
- Monroe, LA
National Provider Identifier
1083900088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17222
- Practice address
- 4103 Pecanland Mall Dr
Monroe, LA 71203-7009 - Phone
- (318) 388-3474
- Fax
- (318) 388-3474
- NPI assigned
- Jun 28, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17222 | LA | Primary |
Addresses
Primary practice location
4103 Pecanland Mall Dr
Monroe, LA 71203-7009
Mailing address
4103 Pecanland Mall Dr
Monroe, LA 71203-7009
Phone (318) 388-3474
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17222 | LA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309219200000",
"number": "1083900088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4103 PECANLAND MALL DR",
"city": "MONROE",
"state": "LA",
"postal_code": "712037009",
"telephone_number": "318-388-3474",
"fax_number": "318-388-3474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4103 PECANLAND MALL DR",
"city": "MONROE",
"state": "LA",
"postal_code": "712037009",
"telephone_number": "318-388-3474",
"fax_number": "318-388-3474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "CANDACE",
"middle_name": "YVETTE",
"name_prefix": "Ms.",
"credential": "PHARM. D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-28",
"last_updated": "2011-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "17222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.