Individual
KEVIN SCOTT HENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 731-0050
(317) 731-0050
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
051781
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
132850
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102328394
ANTHEM PTAN
IN
01
—
264430G03
MEDICARE PTAN
IN
05
—
300069011
—
IN
Enumeration date
05/05/2006
Last updated
04/30/2024
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