Doctor Name: | MRS. MICHELLE DAWN HENSON |
NPI Number: | 1427308881 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | A.P.R.N. |
License Number: | 71004139A |
Business Practice Address: | 301 Henry St Bldg B North Vernon, IN - 472651030 |
Business Phone Number: | 8123524463 |
Business Fax Number: | |
Mailing Address: | 10330 N Meridian St, Suite 201 INDIANAPOLIS |
State: | IN |
Postal Code: | 462901024 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/13/2012 |
NPI Last Update Date: | 11/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 71004139A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |