MEDICARE: VERONICA ERIN HENSON AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	AUD146	HI

General Provider Information

NPI Number	:	1407255763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA ERIN HENSON AU.D.

Provider Business Mailing Address
First Line	:	3120 S RAINBOW BLVD
Second Line	:	STE 202
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6236
Country	:	US
Telephone Number	:	702-233-4327
Fax Number	:	702-233-8837

Provider Business Practice Location Address
First Line	:	3120 S RAINBOW BLVD
Second Line	:	STE 202
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6236
Country	:	US
Telephone Number	:	702-233-4327
Fax Number	:	702-233-8837

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2014
Last Update Date	:	02/19/2015

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