person
Mr. Jesse Lee Henneberg, APN
Neonatal Nurse Practitioner in Peoria, Illinois
NPI 1316299456

Jesse Lee Henneberg is a Neonatal Nurse Practitioner based in Springfield, IL and is specialized in Neonatal. Jesse Lee Henneberg practices in Peoria, IL and has the professional credentials of APN. The NPI Number for Jesse Lee Henneberg is 1316299456 and holds a License No. 209009916 (Illinois).

The current practice location address for Jesse Lee Henneberg is 530 Ne Glen Oak Ave, Peoria, IL and can be reached out via phone at 309-624-0629.

Location: 530 Ne Glen Oak Ave, Peoria, IL, 62702-5131
person
Provider Profile Details
NPI Number
1316299456
Provider Name
Jesse Lee Henneberg
Credential
APN
Provider Entity Type
Individual
Gender
Male
Address
530 Ne Glen Oak Ave, Peoria, IL, 62702-5131
Phone Number
309-624-0629
Fax Number
Provider Enumeration Date
10/14/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
530 Ne Glen Oak Ave
City
State
Zip
61637-0001
Phone Number
309-624-0629
Fax Number
person
Provider Business Mailing Address Details
Address
530 Ne Glen Oak Ave
City
State
Zip
61637-0001
Phone Number
309-624-0629
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Neonatal
Taxonomy
License No.
209009916 (Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Neonatal, Critical Care
Taxonomy
License No.
209009916 (Illinois)
Definition
Definition to come...
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