| NPI | 1386374833 |
|---|---|
| Former Name | KRISSA LEANNE HENDRICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 10855266-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 10855266-3102) |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2023-12-19 |