Provider Demographics
NPI:1508303868
Name:HENDRIX, KIMBERLY D (LVN)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:D
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:DAWN
Other - Last Name:HENDRIX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LVN
Mailing Address - Street 1:8300 FM 1960 RD E
Mailing Address - Street 2:APT 2307
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-4525
Mailing Address - Country:US
Mailing Address - Phone:713-553-6625
Mailing Address - Fax:
Practice Address - Street 1:8300 FM 1960 RD E
Practice Address - Street 2:APT 2307
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-4525
Practice Address - Country:US
Practice Address - Phone:713-553-6625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care