Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 125-054270 | IL |
N | 2080P0205X | Pediatric Endocrinologist | 000000 | TX |
Y | 2080P0205X | Pediatric Endocrinologist | 2021-02195 | NC |
NPI | 1326297292 |
---|---|
Provider Name | Kristen Renata Hendrix |
First Address | Charlotte, NC 28260-0447 |
Second Address | Charlotte, NC 28204-3217 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2008 |
Last Update Date | 08/09/2021 |