Provider Demographics
NPI:1053749853
Name:HENSLEE, ANNELIESA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANNELIESA
Middle Name:
Last Name:HENSLEE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2276 GARDNER RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-8738
Mailing Address - Country:US
Mailing Address - Phone:614-879-9909
Mailing Address - Fax:
Practice Address - Street 1:3720 SOLDANO BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-1422
Practice Address - Country:US
Practice Address - Phone:614-743-7863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-15
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03328610183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist