| Alicia Diane Hensley, AGNP-C | |
|
151 E Bow St, Thorntown, IN 46071-1164 | |
| (765) 436-2400 | |
| (765) 436-7375 |
| Full Name | Alicia Diane Hensley |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 10 Years |
| Location | 151 E Bow St, Thorntown, Indiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346619715 | NPI | - | NPPES |
| 201331770 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 28176948A (Indiana) | Secondary |
| 363LP2300X | Nurse Practitioner - Primary Care | 71005725A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Witham Health Services | Lebanon, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| My Mobile Md Llc | 1052617826 | 25 |
| Witham Memorial Hospital | 4082523170 | 89 |
| Entity Name | Witham Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083750293 PECOS PAC ID: 4082523170 Enrollment ID: O20040519001402 |
| Entity Name | Pike Medical Consultants Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770689242 PECOS PAC ID: 1850495003 Enrollment ID: O20070328000668 |
| Entity Name | My Mobile Md Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225495716 PECOS PAC ID: 1052617826 Enrollment ID: O20160304001699 |
| Mailing Address | Practice Location Address |
|---|---|
| Alicia Diane Hensley, AGNP-C 2605 N Lebanon St, Lebanon, IN 46052-1476 Ph: () - | Alicia Diane Hensley, AGNP-C 151 E Bow St, Thorntown, IN 46071-1164 Ph: (765) 436-2400 |
Barbara S Click, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 151 E Bow St, Thorntown, IN 46071 Phone: 765-436-2400 Fax: 765-436-7573 |