Provider Demographics
NPI:1225328248
Name:HENNESSEY, MARGARET MARIE (FNP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:MARIE
Last Name:HENNESSEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:MARIE
Other - Last Name:BUCKNEER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:404 YAUGER WAY SW STE 100
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-8152
Mailing Address - Country:US
Mailing Address - Phone:564-669-5150
Mailing Address - Fax:564-669-5155
Practice Address - Street 1:404 YAUGER WAY SW STE 100
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8152
Practice Address - Country:US
Practice Address - Phone:564-669-5150
Practice Address - Fax:564-669-5155
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60127191363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily