Provider Demographics
NPI:1821825159
Name:HENIUS, CANTISE (MSN RN)
Entity type:Individual
Prefix:
First Name:CANTISE
Middle Name:
Last Name:HENIUS
Suffix:
Gender:F
Credentials:MSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 LITTLE ST
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39773-2865
Mailing Address - Country:US
Mailing Address - Phone:662-524-9264
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 944
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:MS
Practice Address - Zip Code:39773-0944
Practice Address - Country:US
Practice Address - Phone:734-578-5608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS913827163WG0000X, 163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine