Provider Demographics
NPI:1578984696
Name:HENDRICKS, HANNAH LEIGH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:LEIGH
Last Name:HENDRICKS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 W HWY 54 BLDG 200
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-7848
Mailing Address - Country:US
Mailing Address - Phone:316-260-6030
Mailing Address - Fax:316-260-1019
Practice Address - Street 1:307 W HWY 54 BLDG 200
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:KS
Practice Address - Zip Code:67002-7848
Practice Address - Country:US
Practice Address - Phone:316-260-6030
Practice Address - Fax:316-260-1019
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-15018183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist