MR. Jesse Lee Henneberg, APN

NPI #1316299456 in Peoria, Illinois

Provider Information

NPI Number
1316299456
Entity Type
Individual
Name
MR. Jesse Lee Henneberg, APN
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Nurse Practitioner - Neonatal
Credential
APN
Enumeration Date
Oct 14, 2012
Last Updated
Jul 19, 2021

Practice Location

Address
530 NE GLEN OAK AVE
City
Peoria
ZIP Code
61637-0001
Phone
(309) 624-0629

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner - Neonatal, Critical CareNeonatal, Critical Care
Nurse Practitioner - NeonatalNeonatal

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