Provider Demographics
NPI:1568830867
Name:HENNINGER, YARA (APRN)
Entity Type:Individual
Prefix:
First Name:YARA
Middle Name:
Last Name:HENNINGER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:YARA
Other - Middle Name:
Other - Last Name:ASSAAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:77 NORTHEASTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-3128
Mailing Address - Country:US
Mailing Address - Phone:603-882-3616
Mailing Address - Fax:866-881-9106
Practice Address - Street 1:45 HIGH ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3312
Practice Address - Country:US
Practice Address - Phone:603-821-7788
Practice Address - Fax:603-821-5620
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH072158-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health