Individual
MS. CAROL A HENNESSY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12662 FM 1314 RD, CONROE, TX 77302-3443
(936) 524-8540
Mailing address
PO BOX 158, ESPANOLA, NM 87532-0158
(505) 753-7218
(505) 747-7396
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
250508
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8Y3459
BCBSTX
TX
Enumeration date
06/06/2006
Last updated
03/22/2017
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