Provider Demographics
NPI:1245320787
Name:HENSLEY, JENNIFER ANN (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANN
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2362 MCCLELLAN HWY
Mailing Address - Street 2:
Mailing Address - City:RANGER
Mailing Address - State:WV
Mailing Address - Zip Code:25557-7534
Mailing Address - Country:US
Mailing Address - Phone:304-778-2059
Mailing Address - Fax:
Practice Address - Street 1:2362 MCCLELLAN HWY
Practice Address - Street 2:
Practice Address - City:RANGER
Practice Address - State:WV
Practice Address - Zip Code:25557-7534
Practice Address - Country:US
Practice Address - Phone:304-778-2059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV19933207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine