Doctor Name: | MRS. SALLY RUTH HENSLEY |
NPI Number: | 1003902578 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN, FNP |
License Number: | 12228 |
Business Practice Address: | 153 E Broadway Blvd Jefferson City, TN - 377602517 |
Business Phone Number: | 8654715110 |
Business Fax Number: | 8654715105 |
Mailing Address: | 916 E Highland St, JEFFERSON CITY |
State: | TN |
Postal Code: | 377602726 |
Phone Number: | 8656175081 |
Fax Number: | |
NPI Enumeration Date: | 10/04/2006 |
NPI Last Update Date: | 04/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 12228 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |