Provider Demographics
NPI:1639415599
Name:HENSEL, MICHELE LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:MICHELE
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 1:4704 FECHTER RD
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-2437
Mailing Address - Country:US
Mailing Address - Phone:509-833-6373
Mailing Address - Fax:
Practice Address - Street 1:6513 W CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-1746
Practice Address - Country:US
Practice Address - Phone:509-833-6373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-21
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA129462164W00000X
WAB129462374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No374700000XNursing Service Related ProvidersTechnician