Individual
JODIE HENNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3028 PROVIDENCE ST, SUN PRAIRIE, WI 53590-4585
(608) 213-3897
Mailing address
3028 PROVIDENCE ST, SUN PRAIRIE, WI 53590-4585
(608) 213-3897
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
14557230
WI
Other
Enumeration date
12/20/2016
Last updated
12/20/2016
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