Provider Demographics
NPI:1508446881
Name:HENSON, SARAH CLARISSA (FNP-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:CLARISSA
Last Name:HENSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 TORRIE CIR
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49441-5587
Mailing Address - Country:US
Mailing Address - Phone:231-670-2679
Mailing Address - Fax:
Practice Address - Street 1:923 TORRIE CIR
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49441-5587
Practice Address - Country:US
Practice Address - Phone:231-670-2679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIF04210137163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse