Individual
MICHAEL HENNIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1451 HILLSIDE DR, CLARKS SUMMIT, PA 18411-9504
(570) 586-2011
Mailing address
1451 HILLSIDE DR, CLARKS SUMMIT, PA 18411-9504
(570) 586-2011
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP017524
PA
Other
Enumeration date
06/14/2017
Last updated
07/21/2022
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