Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jessica Emily Hennen, PA-C

Individual provider Physician Assistant · NPI 1205436011

Jessica Emily Hennen, PA-C is a Physician Assistant in Mililani, Hawaii. Qualified in 2020, 6 years ago. Practices with Grima Dermatology and Surgery Inc, a 2-clinician group and accepts Medicare assignment. Licensed in Hawaii, Maine and New Hampshire.

Years since qualifying
6
Licensed in
HI, ME, NH
In the registry since
2020
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

95-390 Kuahelani Ave Ste J-1
Mililani, HI 96789-1192
Phone: (808) 909-3252
Fax: (808) 909-3894
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence AMD-1585 (HI)
Physician Assistant Taxonomy 363A00000X · Licence EL31989 (NH)
Physician Assistant Taxonomy 363A00000X · Licence PA2112 (ME)

Record details

NPI number1205436011
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 30, 2020
Last updated in NPPESMarch 5, 2026
Certification dateMarch 5, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Grima Dermatology And Surgery Inc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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