Healthcare Provider Details

I. General information

NPI: 1639400062
Provider Name (Legal Business Name): LU ANN L. HENSLEY C.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2010
Last Update Date: 01/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 SAINT VINCENTS DR BRUNO CANCER CENTER
BIRMINGHAM AL
35205-1601
US

IV. Provider business mailing address

500 OFFICE PARK DR SUITE 400
BIRMINGHAM AL
35223-2437
US

V. Phone/Fax

Practice location:
  • Phone: 205-939-7880
  • Fax: 205-390-2509
Mailing address:
  • Phone: 205-803-4384
  • Fax: 205-803-4354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-049864
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: