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General NPI Number Information
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NPI Number | 1124626619
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Entity Type | Individual
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Provider Name | ABBEY HENDRICKSON
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Gender | Female
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Dates
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Enumeration Date | 10/15/2020
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 1550 BLAKE AVE
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City | ALBERT LEA
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State | MN
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Zip | 56007-6304
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Country | US
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Telephone | 507-377-0668
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 ABBOTT ST
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City | ALBERT LEA
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State | MN
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Zip | 56007-4409
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 123795
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License Number State | MN
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