Provider Demographics
NPI:1023839867
Name:HANSELL, LLESENIA
Entity type:Individual
Prefix:
First Name:LLESENIA
Middle Name:
Last Name:HANSELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 CONNALY DR
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-5625
Mailing Address - Country:US
Mailing Address - Phone:910-257-3199
Mailing Address - Fax:877-361-7445
Practice Address - Street 1:724 CONNALY DR
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-5625
Practice Address - Country:US
Practice Address - Phone:910-257-3199
Practice Address - Fax:877-361-7445
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist