Doctor Name: | MRS. ASHLEY HENDRICKS |
NPI Number: | 1932532116 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CPNP |
License Number: | A003938 |
Business Practice Address: | 1400 Pershing Hwy Smackover, AR - 717622300 |
Business Phone Number: | 8707253471 |
Business Fax Number: | 8707253215 |
Mailing Address: | 1400 Pershing Hwy, SMACKOVER |
State: | AR |
Postal Code: | 717622300 |
Phone Number: | 8707253471 |
Fax Number: | 8707253215 |
NPI Enumeration Date: | 08/12/2013 |
NPI Last Update Date: | 08/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | A003938 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |