Provider Demographics
NPI:1730440033
Name:HENSLEY, KERRY A (MD)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:A
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:81 HIGHLAND AVE
Mailing Address - Street 2:ATTN MEDICAL STAFF OFFICE
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2714
Mailing Address - Country:US
Mailing Address - Phone:978-646-2100
Mailing Address - Fax:978-646-2120
Practice Address - Street 1:194 R NORTH STREET
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1242
Practice Address - Country:US
Practice Address - Phone:978-646-2100
Practice Address - Fax:978-646-2120
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA262001207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine