MEDICARE: JACQUELINE HENDRICKS

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	405300000X	Prevention Professional	251268	FL

General Provider Information

NPI Number	:	1902451792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE HENDRICKS

Provider Business Mailing Address
First Line	:	4525 DEAN MARTIN DR UNIT 501
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-8107
Country	:	US
Telephone Number	:	904-504-7234
Fax Number	:

Provider Business Practice Location Address
First Line	:	4525 DEAN MARTIN DR UNIT 501
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-8107
Country	:	US
Telephone Number	:	904-504-7234
Fax Number	:

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

Provider Enumeration Date	:	08/07/2019
Last Update Date	:	08/07/2019

Similar Medicare Providers

1841583986 — MARK JAMES BROXTERMAN
Practice Location Address:

8107 CIMARRON MEADOWS WAY
LAS VEGAS, NV
89147-5055

Practice Phone: 702-429-2654
Practice Fax: 702-221-4275

1609136035 — REKINDLED HOPE LLC
Practice Location Address:

8107 CIMARRON MEADOWS WAY
LAS VEGAS, NV
89147-5055

Practice Phone: 702-429-2654
Practice Fax: 702-221-4275

1790555282 — MISS YANEK ALETIA MARTINDALE
Practice Location Address:

10771 DITCHBURN CT
LAS VEGAS, NV
89166-8107

Practice Phone: 702-557-4983
Practice Fax:

1720886211 — MAYRA CORRAL
Practice Location Address:

2955 FOUNTAIN AVE
LAS CRUCES, NM
88007-8107

Practice Phone: 575-520-4948
Practice Fax:

1760322465 — ALL CARE HOSPICE & PALLIATIVE CARE LLC
Practice Location Address:

3824 S JONES BLVD STE F2
LAS VEGAS, NV
89103-2453

Practice Phone: 702-410-0126
Practice Fax:

1205776853 — ANYWHERE CLINIC WASHINGTON PLLC
Practice Location Address:

4029 DEAN MARTIN DR
LAS VEGAS, NV
89103-4138

Practice Phone: 702-848-2256
Practice Fax: 702-817-9443

Directions to “ JACQUELINE HENDRICKS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.