Provider Demographics
NPI: | 1699417121 |
---|---|
Name: | HENION, JENNIFER A (REGISTERED NURSE) |
Entity type: | Individual |
Prefix: | MRS |
First Name: | JENNIFER |
Middle Name: | A |
Last Name: | HENION |
Suffix: | |
Gender: | F |
Credentials: | REGISTERED NURSE |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 3 BELLWOOD DR |
Mailing Address - Street 2: | |
Mailing Address - City: | NEW CITY |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10956-1409 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 845-304-8219 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3 BELLWOOD DR |
Practice Address - Street 2: | |
Practice Address - City: | NEW CITY |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10956-1409 |
Practice Address - Country: | US |
Practice Address - Phone: | 845-304-8219 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2022-04-13 |
Last Update Date: | 2022-04-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 348563-01 | 163WA0400X, 163WA2000X, 163WC0400X, 163WC1500X, 163WC1600X, 163WD0400X, 163WG0000X, 163WG0600X, 163WH0200X, 163WH1000X, 163WI0600X, 163WP0000X, 163WP0808X, 163WW0000X, 163W00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 163W00000X | Nursing Service Providers | Registered Nurse | Group - Multi-Specialty | |
No | 163WA0400X | Nursing Service Providers | Registered Nurse | Addiction (Substance Use Disorder) | |
No | 163WA2000X | Nursing Service Providers | Registered Nurse | Administrator | |
No | 163WC0400X | Nursing Service Providers | Registered Nurse | Case Management | |
No | 163WC1500X | Nursing Service Providers | Registered Nurse | Community Health | |
No | 163WC1600X | Nursing Service Providers | Registered Nurse | Continuing Education/Staff Development | |
No | 163WD0400X | Nursing Service Providers | Registered Nurse | Diabetes Educator | |
No | 163WG0000X | Nursing Service Providers | Registered Nurse | General Practice | Group - Multi-Specialty |
No | 163WG0600X | Nursing Service Providers | Registered Nurse | Gerontology | Group - Multi-Specialty |
No | 163WH0200X | Nursing Service Providers | Registered Nurse | Home Health | Group - Multi-Specialty |
No | 163WH1000X | Nursing Service Providers | Registered Nurse | Hospice | Group - Multi-Specialty |
No | 163WI0600X | Nursing Service Providers | Registered Nurse | Infection Control | Group - Multi-Specialty |
No | 163WP0000X | Nursing Service Providers | Registered Nurse | Pain Management | Group - Multi-Specialty |
No | 163WP0808X | Nursing Service Providers | Registered Nurse | Psychiatric/Mental Health | Group - Multi-Specialty |
No | 163WW0000X | Nursing Service Providers | Registered Nurse | Wound Care | Group - Multi-Specialty |