Laura Ann Henneker, NP
Individual provider Active NPI Family Nurse Practitioner · Cordova, AK
NPI 1376608489 · NPPES record last updated Aug 27, 2024
Key facts
- NPI
- 1376608489
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 138454 (AK)
- Practice address
- PO Box 160
Cordova, AK 99574-0160 - Phone
- (907) 424-8000
- Fax
- (907) 424-8116
- NPI assigned
- Dec 27, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cordova Community Medical Center
Practice addresses (Care Compare)
602 Chase Ave
Cordova, AK 99574-0559
Phone (907) 424-8000
Hospital & facility affiliations
- Cordova Community Medical Center
- Providence Alaska Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190829001701 | AK | Practitioner - Nurse Practitioner | 3971546730 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 138454 | AK | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cordova Community Medical Center | Current |
Accepting new patients | |
| Feather River Hospital | Past |
Accepting new patients | |
| Feather River Hospital | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/cordova-527880fe
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 138454 | AK | Yes |
Addresses
Primary practice location
PO Box 160
Cordova, AK 99574-0160
Mailing address
5125 Skyway
Paradise, CA 95969-5624
Phone (530) 872-2000
Other providers in Cordova, AK
- Alyce L Garrity
- Steve T Goniotakis
- Melissa Guy
- Benjamin Head
- Carly Heidenreich
- Joan Catherine Herschleb
- Aaron Jeffrey Holm
- Brian Iutzi
- Barbara Frances Marie Jewell
- Elizabeth King
All providers in Cordova, AK · Family Nurse Practitioner in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.