Provider Demographics
NPI:1114108750
Name:HENNEN, STELLA NYA (MD, MSPH)
Entity Type:Individual
Prefix:DR
First Name:STELLA
Middle Name:NYA
Last Name:HENNEN
Suffix:
Gender:F
Credentials:MD, MSPH
Other - Prefix:
Other - First Name:STELLA
Other - Middle Name:NYA
Other - Last Name:ARTHUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3033 EXCELSIOR BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-4688
Mailing Address - Country:US
Mailing Address - Phone:612-470-9871
Mailing Address - Fax:
Practice Address - Street 1:3033 EXCELSIOR BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-4688
Practice Address - Country:US
Practice Address - Phone:612-470-9871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN56474207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology