Individual
MELISSA L HENNEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2310 CRAIG RD, EAU CLAIRE, WI 54701-6128
(715) 858-8100
Mailing address
2310 CRAIG RD, EAU CLAIRE, WI 54701-6128
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
128391
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/23/2020
Last updated
07/20/2020
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