Individual provider Active NPI

Angela Dawn Hennies, RN, PHN

  • Registered Nurse
  • Stillwater, MN
National Provider Identifier
1306795968
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
2544495 Issued in MN
Practice address
14790 119TH St N
Stillwater, MN 55082-8906
Phone
(612) 270-0296
NPI assigned
Jan 27, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2544495 MN Primary

Addresses

Primary practice location

14790 119TH St N
Stillwater, MN 55082-8906

Mailing address

14790 119TH St N
Stillwater, MN 55082-8906
Phone (612) 270-0296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2544495MNMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1769472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1306795968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14790 119TH ST N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550828906",
            "telephone_number": "612-270-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14790 119TH ST N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550828906",
            "telephone_number": "612-270-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNIES",
        "first_name": "ANGELA",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "RN, PHN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2544495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.