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General NPI Number Information
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NPI Number | 1962343624
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Entity Type | Individual
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Provider Name | CAREY MICHAEL HENSON MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/04/2026
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Last Update Date | 04/04/2026
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Provider Practice Location Address
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Address Line | 4740 N PENNGROVE WAY
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City | MERIDIAN
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State | ID
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Zip | 83646-7443
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Country | US
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Telephone | 208-938-3663
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Fax | 208-938-3664
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Provider Business Mailing Address
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Address Line | 3245 N WING RD
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City | STAR
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State | ID
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Zip | 83669-5146
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Country | US
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Telephone | 208-871-5869
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Fax | 208-871-5869
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2581102
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License Number State | ID
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