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Individual
SHANAI PETRAKOS HENDRICK
Active
Individual
SHANAI PETRAKOS HENDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3008164
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100400010
—
KY
Enumeration date
09/23/2013
Last updated
01/26/2019
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