Individual
ALICIA HENNESSEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, AGACNP, DNP
Contact information
Practice address
2584 RESERVE ST, ERIE, CO 80516-2505
(720) 607-9207
(720) 738-7873
Mailing address
PO BOX 479, ERIE, CO 80516-0479
(720) 607-9207
(720) 738-7873
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
0994777
CO
363LF0000X
Family Nurse Practitioner
Primary
0994777
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000178345
—
CO
Enumeration date
07/16/2019
Last updated
12/02/2024
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