Provider Demographics
NPI:1720755432
Name:HENNING, FAITH (RN)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:HENNING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:510 FOLIAGE LN
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:IN
Mailing Address - Zip Code:46069-1468
Mailing Address - Country:US
Mailing Address - Phone:317-224-8851
Mailing Address - Fax:
Practice Address - Street 1:510 FOLIAGE LN
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:IN
Practice Address - Zip Code:46069-1468
Practice Address - Country:US
Practice Address - Phone:317-224-8851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28210429A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse