Individual
MS. KATHERYN LOUISE HENNINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
51 SW LEE ST, NEWPORT, OR 97365-3823
(541) 574-5960
(844) 760-0526
Mailing address
36 SW NYE ST, NEWPORT, OR 97365-3821
(541) 265-0445
(844) 760-0526
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
087000310N6
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500742691
—
OR
Enumeration date
10/06/2006
Last updated
05/13/2021
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