Individual
JOHANNA HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
454 E MEDICAL WAY, HEBER CITY, UT 84032-1391
(435) 657-4400
Mailing address
220 CAMPUS BLVD STE 100, WINCHESTER, VA 22601-2896
(540) 536-5100
(540) 536-0235
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5317663-1206
UT
363AS0400X
Surgical Physician Assistant
0110007662
VA
363AS0400X
Surgical Physician Assistant
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Other
Enumeration date
07/29/2008
Last updated
08/12/2021
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