Provider Demographics
NPI:1922373125
Name:HENSON, EMILY LAREE (CNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:LAREE
Last Name:HENSON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-3454
Mailing Address - Country:US
Mailing Address - Phone:513-255-5208
Mailing Address - Fax:
Practice Address - Street 1:9117 CINCINNATI COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-3701
Practice Address - Country:US
Practice Address - Phone:513-229-7585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0034013363LP0808X
OHPN.140596-M-IV315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient