Healthcare Provider Details

I. General information

NPI: 1144019647
Provider Name (Legal Business Name): AMY LAUREN HENSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 PINE ST
ABILENE TX
79601-2451
US

IV. Provider business mailing address

1924 PINE ST
ABILENE TX
79601-2451
US

V. Phone/Fax

Practice location:
  • Phone: 325-670-4333
  • Fax: 833-437-1261
Mailing address:
  • Phone: 325-670-4333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1205299
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: