Healthcare Provider Details

I. General information

NPI: 1720755432
Provider Name (Legal Business Name): FAITH HENNING FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FAITH BARNES RN

II. Dates (important events)

Enumeration Date: 08/30/2021
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12430 N CLARK ST
CARMEL IN
46032-7645
US

IV. Provider business mailing address

12430 N CLARK STREET
CARMEL IN
46032-7645
US

V. Phone/Fax

Practice location:
  • Phone: 317-938-4559
  • Fax:
Mailing address:
  • Phone: 317-938-4559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28210429A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71018549A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: