Individual
AMY RENEE HENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7782 20TH AVE, JENISON, MI 49428-8524
(616) 685-8700
(616) 457-5567
Mailing address
1900 44TH ST SE, KENTWOOD, MI 49508-5008
(616) 685-1808
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301072799
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4308021
—
MI
05
—
4311439
—
MI
05
—
4320797
—
MI
05
—
4877231
—
MI
Enumeration date
05/18/2006
Last updated
12/27/2021
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