Provider Demographics
NPI:1568894152
Name:HENNINGTON, JANNAS ASHLEE (APN)
Entity Type:Individual
Prefix:
First Name:JANNAS
Middle Name:ASHLEE
Last Name:HENNINGTON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:JANNAS
Other - Middle Name:ASHLEE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3725 ASHEBURY PT
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72936-6847
Mailing Address - Country:US
Mailing Address - Phone:501-295-2388
Mailing Address - Fax:
Practice Address - Street 1:3725 ASHEBURY PT
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:AR
Practice Address - Zip Code:72936-6847
Practice Address - Country:US
Practice Address - Phone:501-295-2388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003927363LP0808X
AZ221533363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health