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General NPI Number Information
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NPI Number | 1912939182
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Entity Type | Individual
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Provider Name | DIANE C HENSHAW MD
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Gender | Female
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 10/12/2007
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Provider Practice Location Address
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Address Line | 6501 E 2ND ST
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City | CASPER
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State | WY
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Zip | 82609-4293
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Country | US
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Telephone | 307-235-5433
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Fax | 307-233-4700
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Provider Business Mailing Address
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Address Line | 6501 E 2ND ST
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City | CASPER
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State | WY
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Zip | 82609-4293
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Country | US
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Telephone | 307-235-5433
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Fax | 307-233-4700
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 6076A
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License Number State | WY
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