Individual
GLENNA P. HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13540 HULL STREET RD, MIDLOTHIAN, VA 23112-2107
(804) 739-6142
(804) 739-8923
Mailing address
13540 HULL STREET RD, MIDLOTHIAN, VA 23112-2107
(804) 739-6142
(804) 739-8923
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101229281
VA
207V00000X
Obstetrics & Gynecology Physician
0101229281
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010185475
—
VA
01
—
1001128
SENTARA
VA
01
—
182433
ANTHEM BCBS OF VA
VA
01
—
2138657
MAMSI
VA
01
—
321012
SOUTHERN HEALTH SERVICES
VA
01
—
3962989
AETNA HMO
VA
01
—
4892804
CIGNA
VA
01
—
5348291
CIGNA
VA
01
—
7765699
AETNA LIFE
VA
Enumeration date
07/07/2006
Last updated
04/29/2011
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