Jennifer Sue Henn, ATC, MBA

Primary specialty

Other Specialist/TechnologistTaxonomy code 246Z00000X

License

36002067A Issued in IN

Practice address

5050 N Clinton St
Fort Wayne, IN 46825-5886

Phone

(260) 484-8551

NPI assigned

Mar 30, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration

State licenses

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1477916229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6311 SHADOW RIDGE RUN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044290",
            "telephone_number": "260-580-8974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 N CLINTON ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255886",
            "telephone_number": "260-484-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENN",
        "first_name": "JENNIFER",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "ATC, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "IN",
            "license": "36002067A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hendricks County Hospital
• Hendricks County Hospital
• Elizabeth Jane Hendricks, PAC
• Rebecca Hendrickson
• Nicole Henline, PTA
• Kaitlyn A Henricks
• Kristian Rafael Henriquez Mirandona, M.D
• Henry County Memorial Hospital
• Anthony C Henry, DO
• Ciara Henry

• Other Specialist/Technologist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Other Specialist/Technologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; 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.