Provider Demographics
NPI:1174253835
Name:HENNE, ELSIE ALOH
Entity Type:Individual
Prefix:
First Name:ELSIE
Middle Name:ALOH
Last Name:HENNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 QUAIL HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:OH
Mailing Address - Zip Code:45067-9007
Mailing Address - Country:US
Mailing Address - Phone:513-283-2757
Mailing Address - Fax:
Practice Address - Street 1:633 QUAIL HOLLOW DR
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:OH
Practice Address - Zip Code:45067-9007
Practice Address - Country:US
Practice Address - Phone:513-283-2757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH173097164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse