Provider Demographics
NPI:1316950793
Name:HENSLEY, YOLANDRA J (CST/CSFA)
Entity type:Individual
Prefix:MRS
First Name:YOLANDRA
Middle Name:J
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:CST/CSFA
Other - Prefix:
Other - First Name:JONI
Other - Middle Name:
Other - Last Name:HENSLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CST/CSFA
Mailing Address - Street 1:PO BOX 2394
Mailing Address - Street 2:
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-2394
Mailing Address - Country:US
Mailing Address - Phone:505-792-8596
Mailing Address - Fax:
Practice Address - Street 1:51 CAMINO DE LOS ARBOLES
Practice Address - Street 2:
Practice Address - City:CORRALES
Practice Address - State:NM
Practice Address - Zip Code:87048-9063
Practice Address - Country:US
Practice Address - Phone:505-792-8596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246ZS0410X
NM97468246ZC0007X, 246ZX2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant