Healthcare Provider Details

I. General information

NPI: 1417830506
Provider Name (Legal Business Name): MADELINE SIERRA HENDRIX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7211 BRIDGES RD
CINCINNATI OH
45230-2138
US

IV. Provider business mailing address

7211 BRIDGES RD
CINCINNATI OH
45230-2138
US

V. Phone/Fax

Practice location:
  • Phone: 513-807-1420
  • Fax:
Mailing address:
  • Phone: 513-807-1420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.010406RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: