IndividualActive
Carley Hennessy
NPI 1407227101 · Surgical Physician Assistant · Williston, ND
Provider details
- NPI number
- 1407227101
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- PAC0617 (ND)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1700 11th St W
Williston, ND 58801-4500
Phone: (701) 774-7687
Approximate (ZIP-level) locationGet directions
Mailing address
1700 11th St W
Williston, ND 58801-4500
Registry dates
- Enumerated
- 2015-10-07
- Last updated
- 2021-12-14
- Certified
- 2021-12-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.