Provider Demographics
NPI:1629309851
Name:HENDEE, KATHLEEN LYNNE I
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:LYNNE
Last Name:HENDEE
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 N.MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:WELLSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14895-1250
Mailing Address - Country:US
Mailing Address - Phone:800-640-6446
Mailing Address - Fax:
Practice Address - Street 1:102 N.MAIN ST.
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14895-1250
Practice Address - Country:US
Practice Address - Phone:800-640-6446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117570-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse