| Doctor Name: | MRS. CATHIE SUE HENNEBERRY |
| NPI Number: | 1053398909 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | F.N.P., APRN-BC, MSN |
| License Number: | RN26836 |
| Business Practice Address: | 205 Main St Williston, ND - 588016020 |
| Business Phone Number: | 7015722470 |
| Business Fax Number: | 7015722480 |
| Mailing Address: | 205 Main St, WILLISTON |
| State: | ND |
| Postal Code: | 588016020 |
| Phone Number: | 7015722470 |
| Fax Number: | 7015722480 |
| NPI Enumeration Date: | 12/30/2005 |
| NPI Last Update Date: | 07/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN26836 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |