Individual
KATHLEEN HENECKE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
17 MAIN ST, STE 302, CORTLAND, NY 13045-6615
(607) 753-3798
(607) 753-6677
Mailing address
RD#1 CEMETARY ROAD, FABIUS, NY 13063
(315) 677-9779
(607) 753-6677
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
5323055
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
F380804-1
NY
Other
Enumeration date
06/24/2005
Last updated
09/11/2025
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