Individual
AMY NICOLE HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
740 PARK AVE, ELY, NV 89301-2797
(775) 289-1640
Mailing address
740 PARK AVENUE, ELY, NV 89301
(775) 289-1640
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
171M00000X
NV
Other
Enumeration date
05/11/2015
Last updated
05/11/2015
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