Hennen, Lisa Rae

Hennen, Lisa Rae is an individual health care provider with primary practice located at 720 4Th Ave S , Saint Cloud MN 56301-4498. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Hennen, Lisa Rae can be contacted via phone (320) 308-3191.

Contact Information

Primary practice address
720 4Th Ave S Saint Cloud MN 56301-4498
Phone: (320) 308-3191
Fax: (320) 308-3192
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2121 Minnesota

Profile Details

NPI number 1588644454
LBN Legal business name Hennen, Lisa Rae
Credentials APRN, CNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2006
Last updated Jul 16th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588644454 NPPES
Minnesota MEDICAID 862953600
Minnesota Other P00221874

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