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Individual
TINA R HENDRICK
Active
Individual
TINA R HENDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
01059551
IN
207V00000X
Obstetrics & Gynecology Physician
Primary
01059551A
IN
207V00000X
Obstetrics & Gynecology Physician
56655
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090540768
MEDICARE PTAN
IN
05
—
200945900A
—
IN
01
—
50015141
KY PASSPORT
KY
01
—
521891
ANTHEM
IN
05
—
7100017830
—
KY
01
—
744915
AETNA
IN
Enumeration date
10/20/2006
Last updated
04/03/2024
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