Provider Demographics
NPI:1568239382
Name:HENSLEY, CARLETTA PAULINE
Entity Type:Individual
Prefix:
First Name:CARLETTA
Middle Name:PAULINE
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17610 FARLEY HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079-8393
Mailing Address - Country:US
Mailing Address - Phone:816-255-6603
Mailing Address - Fax:
Practice Address - Street 1:17610 FARLEY HAMPTON RD
Practice Address - Street 2:
Practice Address - City:PLATTE CITY
Practice Address - State:MO
Practice Address - Zip Code:64079-8393
Practice Address - Country:US
Practice Address - Phone:816-255-6603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program