Provider Demographics
NPI:1659521722
Name:HENDRICKS, KATHRYN ELAINE (DNP, PMHNP, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:ELAINE
Last Name:HENDRICKS
Suffix:
Gender:F
Credentials:DNP, PMHNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 CRAMER CREEK CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-2586
Mailing Address - Country:US
Mailing Address - Phone:614-889-5722
Mailing Address - Fax:614-889-9335
Practice Address - Street 1:299 CRAMER CREEK CT
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-2586
Practice Address - Country:US
Practice Address - Phone:614-889-5722
Practice Address - Fax:614-889-5735
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.267811-COA1363LF0000X
OHAPRN.CNP.10222363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily