Individual
GLENMORE HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
7117 BROCKTON AVE, RIVERSIDE, CA 92506-2658
(951) 782-3622
Mailing address
12742 LIMONITE AVE, EASTVALE, CA 92880-9630
(951) 782-2731
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP 14239
CA
Other
Enumeration date
05/10/2007
Last updated
04/22/2023
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