JENNA LEE HENDRICKSON (NPI# 1669875811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669875811 |
| Entity Type | Individual |
| Full Name | JENNA LEE HENDRICKSON |
| Practice Address |
1821 Hillandale Rd Ste 24a Durham NC 27705-2671 |
| Mailing Address |
506 Everett Place Durham NC 27701-0001 |
| Practice Telephone | 4355919383 |
| Mailing Telephone | 5135191652 |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2020-10-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
19299 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2084 N 1700 W, Ste A, Layton, UT 840411100 | 8017738644 | 8019271591 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003242991 | Jenna Hendrickson | Chiropractor | 11411 E Northwest Hwy Ste 107, Dallas, TX 75218-1442 | 2013-09-24 |
| Street Address |
1821 HILLANDALE RD STE 24A |
| City | DURHAM |
| State | NC |
| Zip Code | 27705-2671 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316385982 | Lorven Michael Edralin | Pediatrics | 1821 Hillandale Rd Ste 24a, Durham, NC 27705-2671 | 2013-06-05 |
| 1144829425 | Kyle Joseph Rickards | Physician Assistant | 1821 Hillandale Rd Ste 24a, Durham, NC 27705-2671 | 2020-10-19 |
| 1184275562 | Lauren Polk Smith | Physician Assistant | 1821 Hillandale Rd Ste 24a, Durham, NC 27705-2671 | 2019-09-26 |
| 1487204293 | Jordan Painter Barham | Physician Assistant | 1821 Hillandale Rd Ste 24a, Durham, NC 27705-2671 | 2019-09-13 |
| 1336603075 | Betsy Dickerson | Nurse Practitioner | 1821 Hillandale Rd Ste 24a, Durham, NC 27705-2671 | 2019-01-28 |
| 1306321930 | Emily Paige Oslie | Physician Assistant | 1821 Hillandale Rd Ste 24a, Durham, NC 27705-2671 | 2018-09-28 |
| 1013436435 | Christopher Evan Couch | Physician Assistant | 1821 Hillandale Rd Ste 24a, Durham, NC 27705-2671 | 2017-09-18 |
| 1164941977 | Kenneth Daniel Graham | Physician Assistant | 1821 Hillandale Rd Ste 24a, Durham, NC 27705-2671 | 2017-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371755 | Tyler Beach, Lcsw, Pllc | Social Worker | 2740 Spencer Street, Durham, NC 27705 | 2019-11-20 |
| 1720635477 | Brittany W Fry | Registered Nurse | 2301 Erwin Road, Hafs Building, Room 6670, Durham, NC 27705 | 2019-08-19 |
| 1760968044 | Nicole D Moore | Social Worker | 1921 N. Pointe Dr, Suite 280, Durham, NC 27705 | 2018-07-19 |
| 1144757097 | Emileigh S Dowling | Physical Therapist | 3475 Erwin Rd Bldg 2, Durham, NC 27705 | 2017-05-22 |
| 1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
| 1780131839 | Michael A Fitzpatrick Iv | Physical Therapist | 3475 Erwin Rd Bldg 2nd, Durham, NC 27705 | 2016-09-07 |
| 1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
| 1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
| 1720486988 | Jennifer Dawn Pace | Physician Assistant | 1821 Hillandale Road Suite 24a, Duke Urgent Care, Durham, NC 27705 | 2014-12-19 |
| 1942612106 | Rachel Hibberd | Psychologist | 508 Fulton Avenue, Durham Va Medical Center, Durham, NC 27705 | 2014-05-22 |
| Find all providers in zip 27705 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528511102 | Tara Lynn West | Nurse Practitioner | 2300 Erwin Rd, Durham, NC 27707 | 2016-07-29 |
| 1285017863 | Danielle Sturkey | Nurse Practitioner | 2301 Erwin Road Box 3090/duke North 7506, Durham, NC 27710-4642 | 2015-07-01 |
| 1720472400 | Alexandra Megan Jackson | Nurse Practitioner | 6301 Herndon Road, Durham, NC 27713 | 2015-03-20 |
| 1538438882 | Lori Christine Walczyk | Nurse Practitioner | 5524 Hospital N, 100500 Med Center, Durham, NC 27710-0001 | 2011-12-15 |
| 1619207032 | Brenda Ward Poirier | Nurse Practitioner | 2415 E Geer St, Glenn Elementary School Wellness Center, Durham, NC 27704-3717 | 2010-01-07 |
| 1558588640 | Christine Hiller | Nurse Practitioner | 1301 Erwin Rd, Dumc 3474, Durham, NC 27710-0001 | 2007-04-19 |
| 1033283643 | Ana Maria Fernandez | Nurse Practitioner | 200 Trent Dr Ste 110, Durham, NC 27710-2319 | 2006-11-17 |
| 1770697559 | Lisa Ellen Rasbach | Nurse Practitioner | 3000 Erwin Road Suite 200, Durham, NC 27710 | 2006-08-18 |
| 1245799733 | Melissa Anne Loyd | Nurse Practitioner | 2301 Erwin Rd, Durham, NC 27705-4699 | 2019-03-14 |
| 1083186050 | Kaitlin Campbell | Nurse Practitioner | 2301 Erwin Rd, Durham, NC 27705-4699 | 2019-01-01 |
| Find all providers in DURHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.