Provider Demographics
NPI:1710428453
Name:HENEGAR, GINNY
Entity Type:Individual
Prefix:
First Name:GINNY
Middle Name:
Last Name:HENEGAR
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 1:10149 COUNTY ROAD 260
Mailing Address - Street 2:
Mailing Address - City:CARL JUNCTION
Mailing Address - State:MO
Mailing Address - Zip Code:64834-5162
Mailing Address - Country:US
Mailing Address - Phone:620-231-9873
Mailing Address - Fax:620-240-5699
Practice Address - Street 1:10149 COUNTY ROAD 260
Practice Address - Street 2:
Practice Address - City:CARL JUNCTION
Practice Address - State:MO
Practice Address - Zip Code:64834-5162
Practice Address - Country:US
Practice Address - Phone:620-231-9873
Practice Address - Fax:620-240-5699
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula