Healthcare Provider Details

I. General information

NPI: 1366712614
Provider Name (Legal Business Name): SHEILA HENNEN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2012
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 SIOUX TRL NW
PRIOR LAKE MN
55372-9012
US

IV. Provider business mailing address

620 BABCOCK BLVD E
DELANO MN
55328-8603
US

V. Phone/Fax

Practice location:
  • Phone: 952-496-6150
  • Fax:
Mailing address:
  • Phone: 763-401-9032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number4704281519
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5311
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5311
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: