Healthcare Provider Details

I. General information

NPI: 1114504883
Provider Name (Legal Business Name): ISABEL MARIE HENDRICKSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ISABEL MARIE HEFNER MD

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 GALLOWS RD
FALLS CHURCH VA
22042-3307
US

IV. Provider business mailing address

601 RIVER BEND RD
GREAT FALLS VA
22066-2713
US

V. Phone/Fax

Practice location:
  • Phone: 703-776-3154
  • Fax:
Mailing address:
  • Phone: 703-969-3281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: