Provider Demographics
NPI:1508801523
Name:HENSLEY, AMBER RENEE (NP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:RENEE
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 N CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2498
Mailing Address - Country:US
Mailing Address - Phone:931-528-1992
Mailing Address - Fax:931-526-4381
Practice Address - Street 1:203 N CEDAR AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2498
Practice Address - Country:US
Practice Address - Phone:931-528-1992
Practice Address - Fax:931-526-4381
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000128939363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner