Healthcare Provider Details

I. General information

NPI: 1821825159
Provider Name (Legal Business Name): CANTISE HENIUS MSN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 09/22/2024
Certification Date: 09/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 944
WEST POINT MS
39773-0944
US

IV. Provider business mailing address

167 LITTLE ST
WEST POINT MS
39773-2865
US

V. Phone/Fax

Practice location:
  • Phone: 734-578-5608
  • Fax:
Mailing address:
  • Phone: 662-524-9264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number913827
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number913827
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: