Healthcare Provider Details

I. General information

NPI: 1750572905
Provider Name (Legal Business Name): LAUREN E HENDRICKSON AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 MEDICAL CT STE A
CARMEL IN
46032-2986
US

IV. Provider business mailing address

1180 MEDICAL CT STE A
CARMEL IN
46032-2986
US

V. Phone/Fax

Practice location:
  • Phone: 317-818-3490
  • Fax: 317-536-3541
Mailing address:
  • Phone: 317-818-3490
  • Fax: 317-536-3541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number23002419A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: