Provider Demographics
NPI:1306730882
Name:HENDRICKSON, KRISTI L
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:L
Last Name:HENDRICKSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 N 51ST ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68514-9703
Mailing Address - Country:US
Mailing Address - Phone:308-325-5213
Mailing Address - Fax:
Practice Address - Street 1:7410 N 51ST ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68514-9703
Practice Address - Country:US
Practice Address - Phone:308-325-5213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-07
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE372500000XMedicaid
NE372600000XMedicaid
NE3747P1801XMedicaid