Henneberry, Michelle D

Henneberry, Michelle D is an sole proprietor health care provider with primary practice located at 263 State St Suite 23, Bangor ME 04401-5435. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Henneberry, Michelle D can be contacted via phone (207) 945-3615.

Contact Information

Primary practice address
263 State St Suite 23 Bangor ME 04401-5435
Phone: (207) 945-3615
Fax: (207) 945-3444
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R037051 Maine

Profile Details

NPI number 1215988852
LBN Legal business name Henneberry, Michelle D
Credentials PMHNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 16th, 2006
Last updated Dec 17th, 2009 - about 15 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 1215988852 NPPES
Maine MEDICAID 255830000
Maine Other 048586

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