Individual
MRS. ELIZABETH JANE HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
3717 MAPLECREST RD, FORT WAYNE, IN 46815-8424
(260) 486-7334
(260) 486-6447
Mailing address
3717 MAPLECREST RD, FORT WAYNE, IN 46815-8424
(260) 486-7334
(260) 486-6447
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000483A
IN
Other
Enumeration date
06/14/2006
Last updated
03/15/2011
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