Provider Demographics
NPI:1275601866
Name:HENSLEY, JOHANNA LURA (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHANNA
Middle Name:LURA
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 WEDDINGTON BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-3204
Mailing Address - Country:US
Mailing Address - Phone:606-432-2225
Mailing Address - Fax:606-432-0966
Practice Address - Street 1:153 WEDDINGTON BRANCH RD
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-3204
Practice Address - Country:US
Practice Address - Phone:606-432-2225
Practice Address - Fax:606-432-0966
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4688111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY602011100OtherACS
KY000000229187OtherANTHEM BC BS
KY1194563OtherCHA
KY5550493OtherCCN
KY7118419OtherAETNA
KY2180649OtherFIRST HEALTH
KY85002152Medicaid
KYU90495Medicare UPIN
KY85002152Medicaid