Individual
DEREK LEE HENNIGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, FPMHNP
Contact information
Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5111
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5111
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2016020071
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2021005041
MO
Other
Enumeration date
11/05/2020
Last updated
01/14/2025
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