Provider Demographics
NPI:1194217547
Name:HENSLEY, SUSAN ANNETTE (CNM)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ANNETTE
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOHENWALD
Mailing Address - State:TN
Mailing Address - Zip Code:38462-2007
Mailing Address - Country:US
Mailing Address - Phone:931-295-3547
Mailing Address - Fax:931-295-3549
Practice Address - Street 1:543 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HOHENWALD
Practice Address - State:TN
Practice Address - Zip Code:38462
Practice Address - Country:US
Practice Address - Phone:931-295-3547
Practice Address - Fax:931-295-3549
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-01
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife