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NPI 1083550446

NPI 1083550446 : COLIN PATRICK HENDRICKSON EMT-P : CHARLOTTESVILLE, VA

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General NPI Number Information
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    NPI Number           |    1083550446
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    Entity Type          |    Individual 
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    Provider Name        |    COLIN PATRICK HENDRICKSON EMT-P
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/28/2026
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    Last Update Date     |    04/28/2026
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Provider Practice Location Address
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    Address Line         |    1215 LEE ST 
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    City                 |    CHARLOTTESVILLE
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    State                |    VA
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    Zip                  |    22908-0816
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    Country              |    US
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    Telephone            |    434-924-3627
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    68 MOZART LN APT 1112 
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    City                 |    LYNCHBURG
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    State                |    VA
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    Zip                  |    24502-1270
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    146L00000X
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    Taxonomy Name        |    Paramedic
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    License Number       |    E201900094
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    License Number State |    VA
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