Individual
ANGELA HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPN
Contact information
Practice address
2323 WINDISH DR, GALESBURG, IL 61401-9780
(309) 343-2290
(309) 344-4368
Mailing address
2323 WINDISH DR, GALESBURG, IL 61401-9780
(309) 343-2290
(309) 344-4368
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
041-387426
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
370984175
BRIDGEWAY FEIN
IL
Enumeration date
01/05/2011
Last updated
01/05/2011
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