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General NPI Number Information
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NPI Number | 1184860975
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Entity Type | Individual
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Provider Name | JEFFREY BRIAN HENSLEY CRNA
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Gender | Male
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Dates
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Enumeration Date | 12/28/2008
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Last Update Date | 10/30/2020
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Provider Practice Location Address
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Address Line | 9423 E 95TH CT
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City | TULSA
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State | OK
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Zip | 74133-5805
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Country | US
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Telephone | 918-893-9445
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Fax | 918-893-9498
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Provider Business Mailing Address
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Address Line | 15900 N SHERIDAN RD
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City | COLLINSVILLE
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State | OK
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Zip | 74021-5975
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Country | US
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Telephone | 918-899-5918
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Fax | 918-272-9634
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 79121
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License Number State | OK
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