Individual
KELLY HENSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, PMHNP-BC
Contact information
Practice address
100 LEDGEHILL RD, BENNINGTON, VT 05201-2273
(802) 442-5491
(802) 442-3363
Mailing address
100 LEDGEHILL RD, BENNINGTON, VT 05201-2273
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
2011009785
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
101-0086139
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020592
—
VT
01
—
Y400364730
MEDICARE PTAN
VT
Enumeration date
03/29/2012
Last updated
07/02/2021
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