Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Henrietta Bannerman

Individual provider Registered Nurse · NPI 1477974095

Henrietta Bannerman is a Nurse Practitioner in Hackensack, New Jersey. Qualified in 2023, 3 years ago. Practices as a sole proprietor, works from 2 locations and offers telehealth. Licensed in New Jersey and New York.

Years since qualifying
3
Licensed in
NJ, NY
In the registry since
2013
Specialties on file
4
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Practice location Address checks out

2 University Plz
Hackensack, NJ 07601-6202
Phone: (212) 203-1773
Fax: (646) 665-4427
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 274 Madison Ave, New York, NY 10016-0701 — (212) 203-1773

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 26NJ14928000 (NJ)
Registered Nurse Taxonomy 163W00000X · Licence 678130 (NY)
Registered Nurse Taxonomy 163W00000X · Licence 26NR20490500 (NJ)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 405453 (NY)

Record details

NPI number1477974095
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 27, 2013
Last updated in NPPESJuly 10, 2025
Certification dateJuly 10, 2025
Mailing address274 Madison Ave Rm 1501, New York, NY 10016-0701

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services

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