Individual
AUTUMN NICOLE HENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
397 LITTLE NECK RD STE 120, VIRGINIA BEACH, VA 23452-5774
(757) 395-1600
Mailing address
397 LITTLE NECK RD STE 120, VIRGINIA BEACH, VA 23452-5774
(757) 395-1600
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024182744
VA
363LF0000X
Family Nurse Practitioner
2012028199
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265789853
—
MO
01
—
431560263
TRICARE
MO
01
—
P01106285
RR MCR
MO
Enumeration date
08/14/2012
Last updated
09/26/2023
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