Healthcare Provider Details

I. General information

NPI: 1730406133
Provider Name (Legal Business Name): SOPHIA NADINE HENDRICKS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SOPHIA NADINE STEPHENS-HENDRICKS CRNP

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3893 WILLIAM PENN HWY
MONROEVILLE PA
15146-2127
US

IV. Provider business mailing address

6375 PENN AVE STE B
PITTSBURGH PA
15206-4010
US

V. Phone/Fax

Practice location:
  • Phone: 412-372-4079
  • Fax:
Mailing address:
  • Phone: 724-948-1050
  • Fax: 724-618-4096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP012001
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP012001
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF336105
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5006499
License Number StateNC
# 5
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP034849
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: