| NPI | 1083191076 |
|---|---|
| Former Name | JOHNITA HENDRICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0001146) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: DE L1-0035771) |
| 163W00000X Registered Nurse (Licence: MD AC006538) | |
| 363L00000X Nurse Practitioner (Licence: DE LG-0001146) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MD AC006538) | |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2024-08-23 |