Provider Demographics
NPI:1679266464
Name:HENDRIX, PAMELA ANN (RN, IBCLC, RLC)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ANN
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:RN, IBCLC, RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6011 LOMBARD CT
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-6318
Mailing Address - Country:US
Mailing Address - Phone:954-304-0843
Mailing Address - Fax:
Practice Address - Street 1:6011 LOMBARD CT
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-6318
Practice Address - Country:US
Practice Address - Phone:954-304-0843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1861742163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant