Provider Demographics
NPI:1275013096
Name:HENSARLING, DINA LYNN (LVN)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:LYNN
Last Name:HENSARLING
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 SWISS DR # 158
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-2733
Mailing Address - Country:US
Mailing Address - Phone:817-304-6251
Mailing Address - Fax:
Practice Address - Street 1:325 SWISS DR # 158
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-2733
Practice Address - Country:US
Practice Address - Phone:817-304-6251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX165298164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse