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Individual

ANN LOUISE HENELT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1301 BERTHA HOWE AVE, SUITE 8, MESQUITE, NV 89027-7502
(702) 346-1700
(702) 346-3563
Mailing address
1301 BERTHA HOWE AVE, SUITE 8, MESQUITE, NV 89027-7502
(702) 346-1700
(702) 346-3563

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
AH010464
MI
208600000X
Surgery Physician
Primary
DO1535
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020026511
RAILROAD MEDICARE
MI
01
0250306465
BCBS MI PROV #
MI
01
17-31077
PHP PROVIDER #
MI
01
1836555
UNITED HEALTHCARE
MI
01
21618
HEALTH PLAN OF MI
MI
05
3013361
MI
01
9961
COMMUNITY CHOICE MI
MI
01
AH010464
STATE LICENSE #
MI
01
P82550
BLUE CARE NETWORK
MI
Enumeration date
11/07/2005
Last updated
05/17/2010
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