Individual
JEREMY ROBERT HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
2700 E 29TH ST STE 260, BRYAN, TX 77802-2587
(979) 774-0012
(979) 774-4636
Mailing address
2700 E 29TH ST STE 260, BRYAN, TX 77802-2587
(979) 821-6300
(979) 823-4545
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95155222
CA
163WC0200X
Critical Care Medicine Registered Nurse
844664
TX
163WC0200X
Critical Care Medicine Registered Nurse
91079
NE
363L00000X
Nurse Practitioner
113125
NE
363L00000X
Nurse Practitioner
AP145332
TX
363L00000X
Nurse Practitioner
H158450
IA
363LA2100X
Acute Care Nurse Practitioner
Primary
AP145332
TX
Other
Enumeration date
02/26/2020
Last updated
01/27/2025
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