Individual
AMY L HENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 GENESYS PKWY, GRAND BLANC, MI 48439-8065
(810) 606-6137
Mailing address
DEPT CH 17767, PALATINE, IL 60055-7767
(800) 968-6866
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704222049
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4869169
—
MI
05
—
4872431
—
MI
05
—
4872440
—
MI
01
—
AH222049
BLUE CROSS BLUE SHIELD
—
01
—
P00334267
RAILROAD MEDICARE
—
Enumeration date
06/13/2006
Last updated
03/06/2008
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