Provider Demographics
NPI:1619115961
Name:HENSEL, BECKY LYNN (LPN)
Entity Type:Individual
Prefix:MISS
First Name:BECKY
Middle Name:LYNN
Last Name:HENSEL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2871 TOWNSHIP ROAD 124
Mailing Address - Street 2:
Mailing Address - City:CARDINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43315-9520
Mailing Address - Country:US
Mailing Address - Phone:740-802-2018
Mailing Address - Fax:
Practice Address - Street 1:2871 TOWNSHIP ROAD 124
Practice Address - Street 2:
Practice Address - City:CARDINGTON
Practice Address - State:OH
Practice Address - Zip Code:43315-9520
Practice Address - Country:US
Practice Address - Phone:740-802-2018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-25
Last Update Date:2009-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN053427164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse