Provider Demographics
NPI:1811903487
Name:HENSLEY, PAULA L (MD)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:L
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:PO BOX 3874
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87190-3874
Mailing Address - Country:US
Mailing Address - Phone:505-235-6125
Mailing Address - Fax:
Practice Address - Street 1:MSC09 5030 1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-2058
Practice Address - Country:US
Practice Address - Phone:505-272-8244
Practice Address - Fax:505-272-4639
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM95-732084P0800X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM302364Medicare PIN
NMNM302365Medicare PIN