Individual
DEREK HENLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
PO BOX 47159, PLYMOUTH, MN 55447-0159
(763) 559-3779
Mailing address
PO BOX 47159, PLYMOUTH, MN 55447-0159
(763) 559-3779
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3022
MN
Other
Enumeration date
05/06/2024
Last updated
09/12/2024
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