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General NPI Number Information
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NPI Number | 1154239234
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Entity Type | Individual
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Provider Name | KRISTINA LYNN HENDRICKSON
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Gender | Female
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 09/01/2026
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Provider Practice Location Address
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Address Line | NAVAL HEALTH CLINIC HAWAII 840 CENTRAL AVE
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City | JOINT BASE PEARL-HARBOR-HICKAM
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State | HI
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Zip | 96860-4908
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Country | US
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Telephone | 888-683-2778
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Fax |
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Provider Business Mailing Address
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Address Line | 6288 STATE HIGHWAY 17 S
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City | WARDEN
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State | WA
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Zip | 98857-9762
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Country | US
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Telephone |
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Fax | 509-771-2302
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | RN60153399
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License Number State | WA
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