Healthcare Provider Details

I. General information

NPI: 1316901390
Provider Name (Legal Business Name): SHARON L HENDRICKS DNP/ENP/FNP/AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 07/21/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 LUTHER STREET
EADS CO
81036
US

IV. Provider business mailing address

800 W PEARL ST
LAMAR CO
81052-3058
US

V. Phone/Fax

Practice location:
  • Phone: 719-438-5401
  • Fax:
Mailing address:
  • Phone: 719-691-4979
  • Fax: 719-691-7733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number990110
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number170012
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: