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Individual

KAYLEIGH A HENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8527 VALLEY FARM RD, MULBERRY, IN 46058-9802
(765) 430-3263
Mailing address
PO BOX 781076, DETROIT, MI 48278-1008
(317) 528-4800
(317) 865-1479

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71007570A
IN
363LP2300X
Primary Care Nurse Practitioner
28203292A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300008725
IN
01
M47140310
MEDICARE PTAN
IN
Enumeration date
10/09/2017
Last updated
11/17/2025
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