Provider Demographics
NPI:1245117530
Name:HENSLEY, KIMBERLY ANN EDWARDS (PMHNP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN EDWARDS
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 E COUNTY LINE RD STE E
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1068
Mailing Address - Country:US
Mailing Address - Phone:317-777-1034
Mailing Address - Fax:
Practice Address - Street 1:549 E COUNTY LINE RD STE E
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1068
Practice Address - Country:US
Practice Address - Phone:317-777-1034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-19
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71016896A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health