Individual
KATHRYN HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2700 BAKER ST FL 3, MUSKEGON, MI 49444-2157
(231) 737-1335
Mailing address
2700 BAKER ST FL 3, MUSKEGON, MI 49444-2157
(231) 737-1335
(231) 737-0534
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601007059
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750772455
—
MI
Enumeration date
02/17/2015
Last updated
03/09/2020
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