Theresa Ann Hennessey
Pediatric Orthopaedic Surgeon
Shriners Hospitals For Children Fairfax Road At Virginia Street
Salt Lake City
, Utah 84103-4399
Theresa Ann Hennessey
Pediatric Orthopaedic Surgeon
Shriners Hospitals For Children Fairfax Road At Virginia Street
Salt Lake City
, Utah 84103-4399
(813) 281-8113
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About
Features
Specialties
- Pediatric Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Theresa Ann Hennessey
- Shriners Hospitals For Children Salt Dept 5034
- Los Angeles, CA
- Zip : 90084-0001
- Fax : (813) 281-8113
- Phone : (813) 281-8478
Second Address
- Theresa Ann Hennessey
- Shriners Hospitals For Children Fairfax Road At Virginia Street
- Salt Lake City, UT
- Zip : 84103-4399
- Fax : (801) 536-3868
- Phone : (801) 536-3600
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 5897436-1205 | UT |
National Provider Identifier
| NPI | 1699826693 |
|---|---|
| Provider Name | Theresa Ann Hennessey |
| First Address | Los Angeles, CA 90084-0001 |
| Second Address | Salt Lake City, UT 84103-4399 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/01/2007 |
| Last Update Date | 17/09/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 5897436-1205 | STATE LICENSE (01) | UT |
| 5897436-8905 | CONTROLLED SUBSTANCE LIC (01) | UT |
| BH9108273 | DEA LICENSE (01) | UT |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.