IndividualActive
Tykerria Henderson
NPI 1104775865 · Geriatric Medicine (Family Medicine) Physician · Port Gibson, MS
Provider details
- NPI number
- 1104775865
- Entity type
- Individual
- Primary specialty
- Geriatric Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Sex
- Female
- Sole proprietor
- No
- License
- 922851 (MS)
Mailing address
30 Pinehurst St
Port Gibson, MS 39150-2850
Registry dates
- Enumerated
- 2026-01-26
- Last updated
- 2026-01-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.