| NPI | 1841295300 |
|---|---|
| Former Name | COLLEEN A HENNING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209001000) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A054401) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2015-04-29 |