Provider Demographics
NPI:1821126087
Name:HENSLEY, BRENDA KARIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:KARIN
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3829 ACADIA DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48360-2726
Mailing Address - Country:US
Mailing Address - Phone:734-740-3448
Mailing Address - Fax:
Practice Address - Street 1:46325 W 12 MILE RD STE 160
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2460
Practice Address - Country:US
Practice Address - Phone:248-344-0877
Practice Address - Fax:248-344-0833
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032834183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist