Doctor Name: | MARK S HENSLEY |
NPI Number: | 1003867888 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ARNP |
License Number: | G070877 |
Business Practice Address: | 302 Ne 14th St Leon, IA - 50144 |
Business Phone Number: | 6414462383 |
Business Fax Number: | 6414462382 |
Mailing Address: | 302 Ne 14th St, LEON |
State: | IA |
Postal Code: | 50144 |
Phone Number: | 6414462383 |
Fax Number: | 6414462382 |
NPI Enumeration Date: | 05/15/2006 |
NPI Last Update Date: | 05/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | G070877 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |