Provider Demographics
NPI:1427842533
Name:HENNIS, ALEXANDER (NRP FP-C)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:HENNIS
Suffix:
Gender:
Credentials:NRP FP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1159 OWL LN
Mailing Address - Street 2:
Mailing Address - City:HARDY
Mailing Address - State:VA
Mailing Address - Zip Code:24101-4241
Mailing Address - Country:US
Mailing Address - Phone:206-468-9015
Mailing Address - Fax:
Practice Address - Street 1:345 WESTLAKE RD
Practice Address - Street 2:
Practice Address - City:HARDY
Practice Address - State:VA
Practice Address - Zip Code:24101-3993
Practice Address - Country:US
Practice Address - Phone:206-468-9015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-05
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPMD520701146L00000X
VAE201902452146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic