Individual
KELSI MARIE HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 TRILLIUM WAY, CORBIN, KY 40701-8426
(606) 528-1212
Mailing address
1 TRILLIUM WAY, CORBIN, KY 40701-8426
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1162589
KY
363L00000X
Nurse Practitioner
Primary
4015202
KY
Other
Enumeration date
12/12/2023
Last updated
01/16/2024
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