Henslee, Mary Roseann
Henslee, Mary Roseann is an individual health care provider with primary practice located at 14557 Highway 19 Ste A , Griffin GA 30224-9582. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Henslee, Mary Roseann can be contacted via phone (678) 688-1580.Contact Information
Primary practice address
14557 Highway 19 Ste A
Griffin GA 30224-9582
Phone: (678) 688-1580
Fax: (678) 688-1594
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | RN141558 | Georgia |
Profile Details
| NPI number | 1063563468 |
|---|---|
| LBN Legal business name | Henslee, Mary Roseann |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 15th, 2007 |
| Last updated | Feb 12th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063563468 | NPPES |
| Georgia | MEDICAID | 487848115D |
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