Hennessee, Alicia

Hennessee, Alicia is an individual health care provider with primary practice located at 1225 N Grand Ave Ste 100 , Pueblo CO 81003-2865. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Hennessee, Alicia can be contacted via phone (719) 544-5600.

Contact Information

Primary practice address
1225 N Grand Ave Ste 100 Pueblo CO 81003-2865
Phone: (719) 544-5600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 0994777 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0994777 Colorado

Profile Details

NPI number 1174176457
LBN Legal business name Hennessee, Alicia
Credentials FNP, AGACNP, DNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2019
Last updated Jan 20th, 2023 - about 3 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 1174176457 NPPES
Colorado MEDICAID 9000178345

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