Provider Demographics
NPI:1548290331
Name:HENSLEY, LORRAINE HANSEN (APRN)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:HANSEN
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2487
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585
Mailing Address - Country:US
Mailing Address - Phone:843-333-0093
Mailing Address - Fax:
Practice Address - Street 1:531 LAFAYETTE CIR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440-2569
Practice Address - Country:US
Practice Address - Phone:843-546-5593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN2369363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology