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General NPI Number Information
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NPI Number | 1053915397
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Entity Type | Individual
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Provider Name | JACQUELINE LEE HENSLEY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/27/2020
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Last Update Date | 11/27/2020
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Provider Practice Location Address
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Address Line | 533 SKIDMORE DR
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City | HARLAN
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State | KY
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Zip | 40831-1703
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Country | US
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Telephone | 606-573-7334
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Fax | 606-573-2113
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Provider Business Mailing Address
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Address Line | 1825 HIGHWAY 1137 PO BOX 374
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City | CAWOOD
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State | KY
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Zip | 40815
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Country | US
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Telephone | 606-505-7554
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 013431
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License Number State | KY
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