Healthcare Provider Details

I. General information

NPI: 1265586762
Provider Name (Legal Business Name): VICTORIA R HENSLEY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 08/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 RED MILE PLACE
LEXINGTON KY
40504
US

IV. Provider business mailing address

644 AUTUMNWOOD DR
RICHMOND KY
40475
US

V. Phone/Fax

Practice location:
  • Phone: 859-288-4053
  • Fax: 859-288-4084
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number4783-P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: