Provider Demographics
NPI:1669621710
Name:HENSLEY, CRYSTAL JONES (PA-C)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:JONES
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2617 S ELM PL
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-7850
Mailing Address - Country:US
Mailing Address - Phone:918-455-4541
Mailing Address - Fax:918-449-9743
Practice Address - Street 1:817 S ELM PL STE 106
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-5369
Practice Address - Country:US
Practice Address - Phone:918-928-5437
Practice Address - Fax:888-720-8944
Is Sole Proprietor?:No
Enumeration Date:2008-09-13
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP-T0813363A00000X
OK1847363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant