Individual
JANELLE L HENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11851 DETROIT AVE, LAKEWOOD, OH 44107-3016
(216) 529-7125
(216) 529-7196
Mailing address
11851 DETROIT AVE, LAKEWOOD, OH 44107-3016
(216) 529-7125
(216) 529-7196
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35087788
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000489304
ANTHEM BC/BS
OH
05
—
2681325
—
OH
01
—
341542312141
CARESOURCE
OH
01
—
351484
WELLCARE
OH
01
—
736086
BCHP
OH
01
—
P00342586
CARERR
OH
01
—
P00717460
RAILROAD CARE
OH
Enumeration date
08/31/2006
Last updated
08/19/2009
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