Healthcare Provider Details

I. General information

NPI: 1982678793
Provider Name (Legal Business Name): MICHELE M. HENSLEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 10/30/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1554 WESLEY WAY
LANCASTER OH
43130
US

IV. Provider business mailing address

1350 RIDGE RD NE
LANCASTER OH
43130
US

V. Phone/Fax

Practice location:
  • Phone: 740-687-6386
  • Fax: 740-687-1388
Mailing address:
  • Phone: 614-215-2379
  • Fax: 740-687-1388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35077053
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: