Provider Demographics
NPI:1689634040
Name:HOENIG, JENNIFER RENAI (ATC)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:RENAI
Last Name:HOENIG
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 HEMLOCK DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-4124
Mailing Address - Country:US
Mailing Address - Phone:910-717-2520
Mailing Address - Fax:
Practice Address - Street 1:5400 RAMSEY ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-1420
Practice Address - Country:US
Practice Address - Phone:910-630-7596
Practice Address - Fax:910-630-7676
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11462255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer