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Individual

DR. KELLEY MARIE HENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
224 W D. L. INGRAM AVENUE, BLDG. 1408, CANNON AFB, NM 88103
(757) 225-6611
Mailing address
224 W D. L. INGRAM AVENUE, BLDG. 1408, CANNON AFB, NM 88103
(757) 902-7154

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0024169514
VA
363LP0200X
Pediatric Nurse Practitioner
APN13239
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1508825902
JAMES BATSON NPI
TN
05
1512646
TN
05
1517710
TN
01
1538173471
COOKEVILLE PEDIATRIC ASSOCIATES
TN
05
3897667
TN
Enumeration date
05/04/2009
Last updated
05/23/2024
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