Healthcare Provider Details

I. General information

NPI: 1679627988
Provider Name (Legal Business Name): MARGARET MARY HENDRICK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 W DAVIES AVE N
LITTLETON CO
80120-5252
US

IV. Provider business mailing address

11812 W LAKE AVE
LITTLETON CO
80127-2326
US

V. Phone/Fax

Practice location:
  • Phone: 303-797-9420
  • Fax: 303-797-9358
Mailing address:
  • Phone: 303-972-6860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number49365
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: