Provider Demographics
NPI:1235024571
Name:HENSON, MADISON FAE
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:FAE
Last Name:HENSON
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 1:4440 BARNES RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-1564
Mailing Address - Country:US
Mailing Address - Phone:719-600-9455
Mailing Address - Fax:719-466-9414
Practice Address - Street 1:4440 BARNES RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-1564
Practice Address - Country:US
Practice Address - Phone:719-600-9455
Practice Address - Fax:719-466-9414
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program