Provider Demographics
NPI:1679966188
Name:HENDRICKSON, JENNIFER (CD(CAPPA))
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HENDRICKSON
Suffix:
Gender:F
Credentials:CD(CAPPA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 ROBERTS AVE
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-2445
Mailing Address - Country:US
Mailing Address - Phone:267-803-6947
Mailing Address - Fax:
Practice Address - Street 1:240 ROBERTS AVE
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2445
Practice Address - Country:US
Practice Address - Phone:267-803-6947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-08
Last Update Date:2015-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula