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TYKERRIA RENEE HENDERSON
NPI 1104775865
Family Medicine - Geriatric Medicine in Port Gibson, MS

Active since January 26, 2026
30 PINEHURST ST, PORT GIBSON, MS 39150(931) 278-9365 Get Directions Write a Review

NPPES record last updated: January 26, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Tykerria Renee Henderson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYKERRIA RENEE HENDERSON (NPI 1104775865) is an individual geriatric medicine provider in Port Gibson, Mississippi, licensed in Mississippi (922851) and active in the NPI registry since January 2026.

NPPES Registry Identity

NPI1104775865
Entity TypeIndividualFemale
Primary Taxonomy207QG0300X
Provider Legal NameTYKERRIA RENEE HENDERSON
Location Address30 PINEHURST STPort Gibson, MS 39150-2850
Mailing Address30 Pinehurst StPort Gibson, MS 39150-2850
Phone(931) 278-9365
Sole ProprietorNo
Enumeration DateJanuary 26, 2026
NPPES CertifiedJanuary 26, 2026
✔ NPI 1104775865 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QG0300X
License✔ Licensed in MS · 922851
Definition
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.
30 PINEHURST ST, Port Gibson, MS 39150
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tykerria Henderson's NPI number?

The NPI number for Tykerria Henderson is 1104775865. It was assigned to this individual provider in the NPPES registry on January 26, 2026.

Where is Tykerria Henderson located?

Tykerria Henderson practices at 30 Pinehurst St, Port Gibson, MS 39150. The listed phone number is (931) 278-9365.

What is Tykerria Henderson's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Geriatric Medicine, with taxonomy code 207QG0300X.

When was this NPI record last updated?

The NPPES record for Tykerria Henderson was last updated on January 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.