Provider Demographics
NPI:1134513559
Name:HENNING, ALICIA CHERYL (APRN)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:CHERYL
Last Name:HENNING
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 W 3RD ST STE 2000
Mailing Address - Street 2:
Mailing Address - City:HARDINSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40143-2624
Mailing Address - Country:US
Mailing Address - Phone:270-580-4050
Mailing Address - Fax:270-266-4200
Practice Address - Street 1:124 W 3RD ST
Practice Address - Street 2:
Practice Address - City:HARDINSBURG
Practice Address - State:KY
Practice Address - Zip Code:40143-2624
Practice Address - Country:US
Practice Address - Phone:270-580-4050
Practice Address - Fax:270-266-4200
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009249363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily