Individual
JACQUELYN HENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
909 SW MULVANE ST, TOPEKA, KS 66606-1677
(785) 357-0301
(785) 357-6589
Mailing address
1500 SW 10TH AVE, MEDICAL STAFF SERVICES, TOPEKA, KS 66604-1301
(785) 354-6241
(785) 270-4343
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-00673
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068002301
MEDICARE PTAN
KS
Enumeration date
09/24/2014
Last updated
01/10/2020
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