Individual
MALLORY HENSEL
Active
Individual
MALLORY HENSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CRNP, AGPCNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN653855
PA
363LA2200X
Adult Health Nurse Practitioner
Primary
SP018580
PA
363LG0600X
Gerontology Nurse Practitioner
SP018580
PA
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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