=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245116557
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MAURA KATHLEEN HENSEL PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2025
-----------------------------------------------------
Last Update Date | 08/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1700 S LINCOLN AVE
-----------------------------------------------------
City | LEBANON
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17042-7529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-272-6621
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 96 SWEET GUM RD
-----------------------------------------------------
City | SELINSGROVE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17870-8421
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-898-1436
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1835P0018X
-----------------------------------------------------
Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
-----------------------------------------------------
License Number | RP459572
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RP459572
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------