Provider Demographics
NPI:1942364401
Name:HENSON, SHIRLEY CATHERINE (RN)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:CATHERINE
Last Name:HENSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 BOULDER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-5388
Mailing Address - Country:US
Mailing Address - Phone:972-274-1714
Mailing Address - Fax:972-274-1714
Practice Address - Street 1:131 BOULDER CREEK DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-5388
Practice Address - Country:US
Practice Address - Phone:972-274-1714
Practice Address - Fax:972-274-1714
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX623824163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management