Healthcare Provider Details

I. General information

NPI: 1508594458
Provider Name (Legal Business Name): LORI HENDRIX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 HIGHWAY 231 S
TROY AL
36081-3067
US

IV. Provider business mailing address

1330 HIGHWAY 231 S
TROY AL
36081-3058
US

V. Phone/Fax

Practice location:
  • Phone: 334-670-5000
  • Fax:
Mailing address:
  • Phone: 334-670-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06220515
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: