Provider Demographics
NPI:1083276208
Name:HENDRICKSON, ALANA (RDN, CDE)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:HENDRICKSON
Suffix:
Gender:F
Credentials:RDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 AWALAU RD
Mailing Address - Street 2:
Mailing Address - City:HAIKU
Mailing Address - State:HI
Mailing Address - Zip Code:96708-5558
Mailing Address - Country:US
Mailing Address - Phone:808-276-2793
Mailing Address - Fax:
Practice Address - Street 1:640 AWALAU RD
Practice Address - Street 2:
Practice Address - City:HAIKU
Practice Address - State:HI
Practice Address - Zip Code:96708-5558
Practice Address - Country:US
Practice Address - Phone:808-276-2793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered