Provider Demographics
NPI:1508946146
Name:HENSLEY, RHONDA D (NP)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:D
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 1:3101 CYPRESS ST
Mailing Address - Street 2:SUITE 9
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-5286
Mailing Address - Country:US
Mailing Address - Phone:318-345-4839
Mailing Address - Fax:
Practice Address - Street 1:3101 CYPRESS ST
Practice Address - Street 2:SUITE 9
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5286
Practice Address - Country:US
Practice Address - Phone:318-322-9252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP03197363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1548162Medicaid
LA1548162Medicaid
LA5X675Medicare ID - Type Unspecified