MEDICARE: SHARDE N HENDRIX

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	0024196164	VA
2	163W00000X	Registered Nurse	R218161	MD
3	367500000X	Certified Registered Nurse Anesthetist	R218161	MD

General Provider Information

NPI Number	:	1255039772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARDE N HENDRIX

Provider Business Mailing Address
First Line	:	11890 HEALING WAY
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-7917
Country	:	US
Telephone Number	:	240-637-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	11890 HEALING WAY
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-7917
Country	:	US
Telephone Number	:	240-637-4000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2023
Last Update Date	:	04/28/2026

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Directions to “ SHARDE N HENDRIX ” Practice Location

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