Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 055251-23-03 | NH |
NPI | 1043319783 |
---|---|
Provider Name | Lynne Michelle Henning |
First Address | Portsmouth, NH 03801-5892 |
Second Address | Portsmouth, NH 03801-5892 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 08/07/2007 |