Individual
AMBER BRIANA HENEGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
124 HUGHES RD, WATAUGA, TN 37694-3147
(423) 707-4255
Mailing address
124 HUGHES RD, WATAUGA, TN 37694-3147
(423) 707-4255
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN0000085347
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPN0000085347
NURSING LICENSE
TN
Enumeration date
12/01/2020
Last updated
12/01/2020
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