Healthcare Provider Details

I. General information

NPI: 1306250600
Provider Name (Legal Business Name): SARAH ELIZABETH HENSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2014
Last Update Date: 09/12/2022
Certification Date: 09/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE ML 2003
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 417-350-2019
  • Fax:
Mailing address:
  • Phone: 513-636-4432
  • Fax: 513-636-3952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number30722
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number35.132896
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: