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General NPI Number Information
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NPI Number | 1831697226
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Entity Type | Individual
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Provider Name | LAUREN COLBY HENDRICKS ARNP
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Gender | Female
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Dates
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Enumeration Date | 01/31/2018
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Last Update Date | 01/31/2018
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Provider Practice Location Address
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Address Line | 100 WHETSTONE PL STE 205
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32086-5775
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Country | US
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Telephone | 904-819-9925
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Fax |
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Provider Business Mailing Address
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Address Line | 406 HEFFERON DR
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32084-6516
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Country | US
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Telephone | 772-633-3257
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | ARNP9361337
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | RN9361337
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License Number State | FL
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