Individual
KELLY MCPHERSON HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-9252
(336) 716-0567
Mailing address
1347 PINEBLUFF RD, WINSTON SALEM, NC 27103-4729
(910) 625-7306
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
129122
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
6247
NC
Other
Enumeration date
09/13/2019
Last updated
03/12/2026
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