Healthcare Provider Details

I. General information

NPI: 1497043103
Provider Name (Legal Business Name): ANNABELLE HENDRIX D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2011
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9001 STATE LINE RD STE 300
KANSAS CITY MO
64114-3212
US

IV. Provider business mailing address

5450 FORT ST
TRENTON MI
48183-4601
US

V. Phone/Fax

Practice location:
  • Phone: 816-363-2600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5101019359
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License Number2022014782
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: