Provider Demographics
NPI:1528535143
Name:HENSLEY, JOHANNA MORGAN (RN, BSN, CRNA)
Entity type:Individual
Prefix:
First Name:JOHANNA
Middle Name:MORGAN
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:RN, BSN, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 N CASCADE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6866
Mailing Address - Country:US
Mailing Address - Phone:719-636-1201
Mailing Address - Fax:719-636-1326
Practice Address - Street 1:1400 E BOULDER ST STE 2508
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5533
Practice Address - Country:US
Practice Address - Phone:719-365-6999
Practice Address - Fax:719-365-2837
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-01
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR095934163W00000X
TX124424367500000X
COC-APN.0100546-C-CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty