Individual
MALLORY HENSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, CRNP, AGPCNP-BC
Contact information
Practice address
536 RODMAN ST APT A, PHILADELPHIA, PA 19147-1433
(215) 620-2536
Mailing address
536 RODMAN ST APT A, PHILADELPHIA, PA 19147-1433
(215) 620-2536
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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