| Doctor Name: | KELLEY MARIE HENSON |
| NPI Number: | 1205060415 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | APN13239 |
| Business Practice Address: | 57 Beam Ln Suite 202 Fishersville, VA - 229392350 |
| Business Phone Number: | 5409320980 |
| Business Fax Number: | 5409320979 |
| Mailing Address: | Po Box 9007, CHARLOTTESVILLE |
| State: | VA |
| Postal Code: | 229069007 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/04/2009 |
| NPI Last Update Date: | 07/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | APN13239 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |