Individual
MR. EDWARD MACK HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
1181 PADDOCK RD, SMYRNA, DE 19977-9679
(302) 653-9261
(302) 659-6887
Mailing address
1181 PADDOCK RD, SMYRNA, DE 19977-9679
(302) 653-9261
(302) 659-6887
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
LG-0000616
DE
363LF0000X
Family Nurse Practitioner
R159470
MD
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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