MEDICARE: ABIGAIL HENDRICKSON PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	10001897A	IN
2	363A00000X	Physician Assistant	00000000A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518342757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL HENDRICKSON PA

Provider Business Mailing Address
First Line	:	6626 E 75TH ST
Second Line	:	SUITE 500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2805
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1011 MAIN ST
Second Line	:	SUITE 140
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46224-6977
Country	:	US
Telephone Number	:	317-957-9000
Fax Number	:	317-957-9950

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2015
Last Update Date	:	12/09/2024

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Directions to “ ABIGAIL HENDRICKSON PA” Practice Location

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