Provider Demographics
NPI:1902272339
Name:HENDRICKS, ROSS STUART (CRNP)
Entity Type:Individual
Prefix:MR
First Name:ROSS
Middle Name:STUART
Last Name:HENDRICKS
Suffix:
Gender:M
Credentials:CRNP
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Mailing Address - Street 1:2101 HIGHLAND AVE S
Mailing Address - Street 2:STE 350
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-4009
Mailing Address - Country:US
Mailing Address - Phone:205-558-2517
Mailing Address - Fax:205-558-2554
Practice Address - Street 1:5346 STADIUM TRACE PKWY
Practice Address - Street 2:STE 100
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-4583
Practice Address - Country:US
Practice Address - Phone:205-682-8022
Practice Address - Fax:205-682-9446
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-19
Last Update Date:2017-11-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL1-132974363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health