Healthcare Provider Details

I. General information

NPI: 1477415933
Provider Name (Legal Business Name): ISABELLA HENSLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2283 E 17TH PL
TULSA OK
74104
US

IV. Provider business mailing address

6424 BRANDYWINE LN
OKLAHOMA CITY OK
73116-3520
US

V. Phone/Fax

Practice location:
  • Phone: 405-371-2283
  • Fax:
Mailing address:
  • Phone: 405-371-2283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: