Individual
ADA HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
9300 E GREGORY BLVD, RAYTOWN, MO 64133-6523
(866) 825-3227
(484) 450-2617
Mailing address
161 WASHINGTON ST, EIGHT TOWER BRIDGE, SUITE 1400, CONSHOHOCKEN, PA 19428-2083
(866) 825-3227
(484) 450-2617
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
071604
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071604
LICENSE
MO
Enumeration date
08/05/2007
Last updated
08/05/2007
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