Provider Demographics
NPI:1740835867
Name:HENGY, ELISABETH ANN (RN)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:ANN
Last Name:HENGY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ELISABETH
Other - Middle Name:ANN
Other - Last Name:HALE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:5736 SHIPP DR
Mailing Address - Street 2:
Mailing Address - City:WATAUGA
Mailing Address - State:TX
Mailing Address - Zip Code:76148-3418
Mailing Address - Country:US
Mailing Address - Phone:214-784-3196
Mailing Address - Fax:
Practice Address - Street 1:5736 SHIPP DR
Practice Address - Street 2:
Practice Address - City:WATAUGA
Practice Address - State:TX
Practice Address - Zip Code:76148-3418
Practice Address - Country:US
Practice Address - Phone:214-784-3196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX972948163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse