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

Mr. Jesse Lee Henneberg, APN

Individual provider Critical Care Neonatal Nurse Practitioner · NPI 1316299456

Mr. Jesse Lee Henneberg, APN is a Critical Care Neonatal Nurse Practitioner in Peoria, Illinois. Practices as a sole proprietor and works from 2 locations. Licensed in Illinois.

Licensed in
IL
In the registry since
2012
Specialties on file
2
What do these letters mean?
APN — Advanced Practice Nurse
The umbrella title some states use for nurse practitioners and other advanced practice nurses.

See every abbreviation used in this directory →

Practice location Address checks out

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone: (309) 624-0629
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 415 N 9th St Ste 4w16, Springfield, IL 62702-5303 — (217) 545-8000

Specialties & licences

Neonatal Nurse Practitioner (primary) Taxonomy 363LN0000X · Licence 209009916 (IL)
Critical Care Neonatal Nurse Practitioner Taxonomy 363LN0005X · Licence 209009916 (IL)

Record details

NPI number1316299456
Entity typeIndividual (Type 1)
GenderMale
Credentials APN
Sole proprietorYes
NPI enumeratedOctober 14, 2012
Last updated in NPPESJuly 19, 2021
Certification dateJuly 19, 2021

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