Provider Demographics
NPI:1053203919
Name:HENDERSON, BRIA (NP)
Entity type:Individual
Prefix:
First Name:BRIA
Middle Name:
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 ESPERANZA DR
Mailing Address - Street 2:
Mailing Address - City:PORT ALLEN
Mailing Address - State:LA
Mailing Address - Zip Code:70767-6216
Mailing Address - Country:US
Mailing Address - Phone:225-933-6694
Mailing Address - Fax:
Practice Address - Street 1:6450 LOUISIANA HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:BATCHELOR
Practice Address - State:LA
Practice Address - Zip Code:70715
Practice Address - Country:US
Practice Address - Phone:225-412-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA205379363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily