Carly Jo Hennek, PA-C

NPI #1023824406 in Roseville, Minnesota

Provider Information

NPI Number: 1023824406
Entity Type: Individual
Name: Carly Jo Hennek, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Dec 10, 2024
Last Updated: Feb 10, 2025

Practice Location

Address: 2720 FAIRVIEW AVE N STE 200
City: Roseville
State: Minnesota
ZIP Code: 55113-1306
Phone: (651) 633-6883

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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