Henke, Carmen Renee Grande

Henke, Carmen Renee Grande is an individual health care provider with primary practice located at 347 North Smith Avenue Childrens Specialty Clinic Nicu, St Paul MN 55102. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care. Physician Assistants & Advanced Practice Nursing Providers / Neonatal is her primary health care specialty. Henke, Carmen Renee Grande can be contacted via phone (651) 220-6210.

Contact Information

Primary practice address
347 North Smith Avenue Childrens Specialty Clinic Nicu St Paul MN 55102
Phone: (651) 220-6210
Fax: (651) 220-7777
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X R1475155 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care 363LN0005X R1475155 Minnesota

Profile Details

NPI number 1205892833
LBN Legal business name Henke, Carmen Renee Grande
Credentials CNNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2006
Last updated Dec 19th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205892833 NPPES
Minnesota MEDICAID 318656300

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