Shalisa Anne Henson, CNM is a medicare enrolled "Advanced Practice Midwife" in Centralia, Illinois. Her current practice location is
430 N Pleasant Ave, Centralia, Illinois. You can reach out to her office (for appointments etc.) via phone at
(618) 436-8350.
Shalisa Anne Henson is licensed to practice in Illinois (license number 209017353) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1598914905.
Provider's Profile
Full Name | Shalisa Anne Henson |
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Gender | Female |
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Speciality | |
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Experience | Years |
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Location | 430 N Pleasant Ave, Centralia, Illinois |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Shalisa Anne Henson attended and graduated from in
NPI Data:
- NPI Number: 1598914905
- Provider Enumeration Date: 09/10/2008
- Last Update Date: 05/21/2024
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Shalisa Anne Henson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1598914905 | NPI | - | NPPES |
CG2264 | Other | IL | RR GROUP ID |
207988001 | Other | IL | MEDICARE PTAN NUMBER |
P00651305 | Other | IL | RAILROAD MEDICARE |
207988 | Other | IL | MEDICARE GROUP NUMBER |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363L00000X | Nurse Practitioner | 209007259 (Illinois) | Secondary |
367A00000X | Advanced Practice Midwife | 2019040165 (Missouri) | Secondary |
367A00000X | Advanced Practice Midwife | 209017353 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shalisa Anne Henson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Shalisa Anne Henson, CNM 430 N Pleasant Ave, Centralia, IL 62801-3006 Ph: (618) 436-8350 | Shalisa Anne Henson, CNM 430 N Pleasant Ave, Centralia, IL 62801-3006 Ph: (618) 436-8350 |
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