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Individual

MRS. ANDREA LEE HENINGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
729 BEDFORD EULESS RD W, HURST, TX 76053-3939
(817) 282-1001
Mailing address
13601 PRESTON RD, #1000W, DALLAS, TX 75240-4911
(972) 715-5007
(972) 715-5682

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
036954
TX
367500000X
Certified Registered Nurse Anesthetist
150915
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
207153201
TX
05
2231892
OH
01
8608UU
BCBS
TX
Enumeration date
10/13/2005
Last updated
08/16/2011
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