Provider Demographics
NPI:1417503509
Name:HENDRICKS, FELICIA (RD)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:HENDRICKS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46511 N 41ST DR
Mailing Address - Street 2:
Mailing Address - City:NEW RIVER
Mailing Address - State:AZ
Mailing Address - Zip Code:85087-7021
Mailing Address - Country:US
Mailing Address - Phone:623-261-9633
Mailing Address - Fax:
Practice Address - Street 1:10503 W THUNDERBIRD BLVD STE 110
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3047
Practice Address - Country:US
Practice Address - Phone:480-772-9049
Practice Address - Fax:480-409-5049
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered