Provider Demographics
NPI:1073756581
Name:HENSON, JOIA LYNN (CPNP)
Entity Type:Individual
Prefix:
First Name:JOIA
Middle Name:LYNN
Last Name:HENSON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 STILLCREEK DRIVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-3222
Mailing Address - Country:US
Mailing Address - Phone:334-549-9129
Mailing Address - Fax:
Practice Address - Street 1:825 N MAIN ST STE 210
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-2100
Practice Address - Country:US
Practice Address - Phone:937-762-5500
Practice Address - Fax:937-762-5099
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-109959363LP0200X
OHCOA-18180-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2270326OtherCIGNA
OH0161708Medicaid
OH000001000712OtherANTHEM
OH9610324OtherAETNA