Healthcare Provider Details

I. General information

NPI: 1215969100
Provider Name (Legal Business Name): ELIZABETH F. HENSLEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 HIOAKS RD STE B
RICHMOND VA
23225-4072
US

IV. Provider business mailing address

1000 BOULDERS PKWY SUITE 102
NORTH CHESTERFIELD VA
23225-5545
US

V. Phone/Fax

Practice location:
  • Phone: 804-272-5814
  • Fax: 804-560-0232
Mailing address:
  • Phone: 804-320-4243
  • Fax: 804-282-1486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110001705
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: