Provider Demographics
NPI:1740950682
Name:HENSCHEL, HOLLY LANE (PHARMD)
Entity type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:LANE
Last Name:HENSCHEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 EDGEWOOD RD NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52411-6613
Mailing Address - Country:US
Mailing Address - Phone:319-294-9193
Mailing Address - Fax:
Practice Address - Street 1:5050 EDGEWOOD RD NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52411-6613
Practice Address - Country:US
Practice Address - Phone:319-294-9193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24226183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist