Provider Demographics
NPI:1356047948
Name:HENSLEY, MORGAN VICTORIA (CRNP)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:VICTORIA
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-0909
Mailing Address - Country:US
Mailing Address - Phone:301-997-0611
Mailing Address - Fax:
Practice Address - Street 1:23511 HOLLYWOOD RD STE 2
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-5833
Practice Address - Country:US
Practice Address - Phone:301-997-0611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR222451363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily