Individual
MARY HENDRIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3118 S LAFOUNTAIN ST # AT, KOKOMO, IN 46902-3710
(765) 864-4160
Mailing address
8003 CASTLEWAY DR, INDIANAPOLIS, IN 46250-1946
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
28171905A
IN
Other
Enumeration date
09/04/2015
Last updated
01/24/2018
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