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General NPI Number Information
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NPI Number | 1407520620
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Entity Type | Individual
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Provider Name | REBEKAH H. HENDRY NP
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Gender | Female
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 2900 WESTFORK DR
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City | BATON ROUGE
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State | LA
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Zip | 70827-0010
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Country | US
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Telephone | 337-991-9276
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Fax | 337-943-0846
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Provider Business Mailing Address
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Address Line | 1509 DULLES DR
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City | LAFAYETTE
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State | LA
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Zip | 70506-3718
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Country | US
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Telephone | 337-408-0797
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Fax | 337-943-0830
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 221457
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License Number State | LA
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