Provider Demographics
NPI:1871346304
Name:HENDRIX, JENNIFER A (RDN, LDN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12935 LIMBERLOST DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-8705
Mailing Address - Country:US
Mailing Address - Phone:765-860-6275
Mailing Address - Fax:
Practice Address - Street 1:9780 LANTERN RD STE 350
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-4093
Practice Address - Country:US
Practice Address - Phone:317-520-4722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37003999A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered