Provider Demographics
NPI:1215142195
Name:HENDRIX, SONYA ANNETTE (IDC)
Entity type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:ANNETTE
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 W 28TH ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508-3001
Mailing Address - Country:US
Mailing Address - Phone:757-396-7586
Mailing Address - Fax:
Practice Address - Street 1:USS GEORGE WASHINGTON CVN-73
Practice Address - Street 2:MEDICAL DEPARTMENT
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09550
Practice Address - Country:US
Practice Address - Phone:757-396-7586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-13
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman