Provider Demographics
NPI:1184485427
Name:HENNE, DEBRA JO (RN BSN)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:JO
Last Name:HENNE
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:JO
Other - Last Name:WEISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1402 S 100TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98168-1618
Mailing Address - Country:US
Mailing Address - Phone:206-730-6954
Mailing Address - Fax:
Practice Address - Street 1:12040 NE 128TH ST # MS 103
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3013
Practice Address - Country:US
Practice Address - Phone:206-730-6954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00091636163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health