Individual
MRS. CATHIE SUE HENNEBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
F.N.P., APRN-BC, MSN
Contact information
Practice address
1213 15TH AVE W, WILLISTON, ND 58801
(701) 572-7651
Mailing address
1213 15TH AVE W, WILLISTON, ND 58801-3800
(701) 572-7651
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R36163
ND
363LF0000X
Family Nurse Practitioner
RN26836
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1476052
—
ND
Enumeration date
12/30/2005
Last updated
04/15/2019
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