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NPI Code Detail

MEDICARE: LORI HENSON PMHNP

MEDICARE: LORI HENSON PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner3008210KY

General Provider Information

NPI Number : 1568895050
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI HENSON PMHNP
Provider Business Mailing Address
First Line : 1949 GOLDSMITH LN STE 103
Second Line :
City : LOUISVILLE
State : KY
Zip : 40218-3096
Country : US
Telephone Number : 502-641-3847
Fax Number : 502-785-4003
Provider Business Practice Location Address
First Line : 1949 GOLDSMITH LN STE 103
Second Line :
City : LOUISVILLE
State : KY
Zip : 40218-3096
Country : US
Telephone Number : 502-641-3847
Fax Number : 502-785-4003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2013
Last Update Date : 04/20/2020

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