Provider Demographics
NPI:1477734713
Name:HENDON, AMY MARIE (APN-BC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MARIE
Last Name:HENDON
Suffix:
Gender:F
Credentials:APN-BC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:MAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN-BC
Mailing Address - Street 1:PO BOX 23229
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42304-3229
Mailing Address - Country:US
Mailing Address - Phone:270-688-1330
Mailing Address - Fax:270-688-1338
Practice Address - Street 1:510 RUBY DR
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-2168
Practice Address - Country:US
Practice Address - Phone:270-399-7900
Practice Address - Fax:270-399-7910
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005344363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000590421OtherANTHEM BCBS
KY000000722784OtherBCBS- MADISONVILLE WALMART CLINIC
KY7100062620Medicaid
KY00503044Medicare PIN
KY000000590421OtherANTHEM BCBS
KYP400025230Medicare PIN
KYK011760Medicare PIN
KY00280092Medicare PIN
KY000000722784OtherBCBS- MADISONVILLE WALMART CLINIC