Provider Demographics
NPI:1912939182
Name:HENSHAW, DIANE C (MD)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:C
Last Name:HENSHAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:C
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6501 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-4293
Mailing Address - Country:US
Mailing Address - Phone:307-235-5433
Mailing Address - Fax:307-233-4700
Practice Address - Street 1:6501 E 2ND ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4293
Practice Address - Country:US
Practice Address - Phone:307-235-5433
Practice Address - Fax:307-233-4700
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY6076A207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY21345Medicare PIN
F85353Medicare UPIN