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General NPI Number Information
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NPI Number | 1811375207
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Entity Type | Individual
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Provider Name | KEVIN L HENDRICKSON NP
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Gender | Male
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Dates
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Enumeration Date | 05/18/2015
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 1131 S ORANGE AVE
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City | ORLANDO
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State | FL
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Zip | 32806-1226
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Country | US
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Telephone | 941-444-0011
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Fax | 603-952-3900
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Provider Business Mailing Address
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Address Line | PO BOX 3868
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City | EVANSVILLE
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State | IN
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Zip | 47737-3868
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Country | US
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Telephone | 812-426-9355
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Fax | 812-858-4539
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28157005A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 71005723A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11037740
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License Number State | FL
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