Provider Demographics
NPI:1730370511
Name:HENDRIKS, CATHY MARIE (RN, MSN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:MARIE
Last Name:HENDRIKS
Suffix:
Gender:F
Credentials:RN, MSN, CPNP
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Mailing Address - Street 1:PO BOX 120427
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-9627
Mailing Address - Country:US
Mailing Address - Phone:210-223-3543
Mailing Address - Fax:210-227-0282
Practice Address - Street 1:315 N SAN SABA STE 1075
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3155
Practice Address - Country:US
Practice Address - Phone:210-223-3543
Practice Address - Fax:210-227-0282
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX650151363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics