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Individual

ELNORA JONES HENDRICKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
200 TUGGLE RD, PROSPECT, VA 23960-7917
(434) 392-9366
Mailing address
200 TUGGLE RD, PROSPECT, VA 23960-7917
(434) 392-9366

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001049702
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001049702
STATE LICENCSE #
VA
Enumeration date
06/16/2011
Last updated
06/16/2011
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