Provider Demographics
NPI:1699029207
Name:HENSLEY, NINA (APRN)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 MEMORIAL DR STE 2
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-6196
Mailing Address - Country:US
Mailing Address - Phone:606-598-8813
Mailing Address - Fax:
Practice Address - Street 1:509 MEMORIAL DR STE 2
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-6196
Practice Address - Country:US
Practice Address - Phone:606-598-8813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-04
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007765363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily