Individual
PATRICIA LYNN HENNEQUIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN, IBCLC
Contact information
Practice address
2378 SCHILLER RD, EMMETT, ID 83617-9747
(208) 345-4647
Mailing address
2378 SCHILLER RD, EMMETT, ID 83617-9747
(208) 345-4647
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
N-32346
ID
Other
Enumeration date
05/28/2020
Last updated
05/28/2020
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