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Individual

AMANDA SUE HENDRICKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1230 WOODLAND DR STE 211, ELIZABETHTOWN, KY 42701-2792
(270) 982-2500
(270) 982-2501
Mailing address
1230 WOODLAND DR STE 211, ELIZABETHTOWN, KY 42701-2792
(270) 982-2500
(270) 982-2501

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3006944
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12250853
CAQH
05
7100170880
KY
Enumeration date
06/02/2011
Last updated
05/03/2023
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