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Individual

ANGELA FRANCIS HENDRIKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
5293 JONES RESERVE WALK, POWDER SPRINGS, GA 30127-9209
(770) 256-7529
Mailing address
5293 JONES RESERVE WALK, POWDER SPRINGS, GA 30127-9209
(770) 256-7529

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN092786
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20160318
LA STATE BOARD OF PRACTICAL NURSING
LA
01
LPN092786
STATE OF GA BOARD OF PRACTICAL NURSING
GA
Enumeration date
12/18/2020
Last updated
12/18/2020
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