Healthcare Provider Details

I. General information

NPI: 1407735202
Provider Name (Legal Business Name): MRS. CHRISTINA HENSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 GARDEN CITY DR
HYATTSVILLE MD
20785-2418
US

IV. Provider business mailing address

8 ALLSPICE CT
OWINGS MILLS MD
21117-1328
US

V. Phone/Fax

Practice location:
  • Phone: 800-777-7904
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR206777
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: