Individual
MIKENZIE HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
228 W 200 S, KAMAS, UT 84036-9010
(435) 783-4385
Mailing address
948 W VAHE ST, DRAPER, UT 84020-8416
(801) 859-5939
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
13416827-1206
UT
363A00000X
Physician Assistant
Primary
13416827-1206
UT
Other
Enumeration date
02/27/2024
Last updated
03/27/2026
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