Individual
CHRISANNE HENNICKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 LOTHROP ST, PITTSBURGH, PA 15213-2536
(412) 647-3685
Mailing address
115 HELENA ST, ELIZABETH, PA 15037-2440
(412) 896-1423
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA-002764-L
PA
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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