Provider Demographics
NPI:1770662538
Name:HENSLEY, BRANNA JO-CHAPMAN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:BRANNA
Middle Name:JO-CHAPMAN
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 1:109 CEDAR KNOLL CT
Mailing Address - Street 2:
Mailing Address - City:LABADIE
Mailing Address - State:MO
Mailing Address - Zip Code:63055-1055
Mailing Address - Country:US
Mailing Address - Phone:636-742-4278
Mailing Address - Fax:
Practice Address - Street 1:851 E 5TH ST STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-3129
Practice Address - Country:US
Practice Address - Phone:636-239-8585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO146831363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP69454Medicare UPIN