Provider Demographics
NPI:1689373185
Name:HENDRY, MICHAL ABELLON (FNP)
Entity Type:Individual
Prefix:MS
First Name:MICHAL
Middle Name:ABELLON
Last Name:HENDRY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17075 DEVONSHIRE ST STE 303
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-5412
Mailing Address - Country:US
Mailing Address - Phone:818-488-1840
Mailing Address - Fax:
Practice Address - Street 1:17075 DEVONSHIRE ST STE 303
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-5412
Practice Address - Country:US
Practice Address - Phone:818-488-1840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-23
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95024284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily