| Amanda Hendricks, Aprn, Pllc | |
|
1230 Woodland Dr Ste 211 Elizabethtown KY 42701-2792 | |
| (270) 982-2500 | |
| (270) 982-2501 |
| Full Name | Amanda Hendricks, Aprn, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1230 Woodland Dr Ste 211, Elizabethtown, Kentucky |
| Authorized Official Name and Position | Amanda Sue Hendricks (OWNER) |
| Authorized Official Contact | 2703073905 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Hendricks, Aprn, Pllc 1230 Woodland Dr Ste 211 Elizabethtown KY 42701-2792 Ph: (270) 982-2500 | Amanda Hendricks, Aprn, Pllc 1230 Woodland Dr Ste 211 Elizabethtown KY 42701-2792 Ph: (270) 982-2500 |
| NPI Number | 1396452934 |
|---|---|
| Provider Enumeration Date | 11/02/2022 |
| Last Update Date | 05/03/2023 |
| Medicare PECOS PAC ID | 3779957758 |
|---|---|
| Medicare Enrollment ID | O20230314001587 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396452934 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Amanda S Hendricks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679867014 PECOS PAC ID: 6901075803 Enrollment ID: I20110810000558 |
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