Provider Demographics
NPI:1841186418
Name:HENDRICKS, ELIZABETH ANN (MSN, APRN, ACNPC-AG)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:HENDRICKS
Suffix:
Gender:F
Credentials:MSN, APRN, ACNPC-AG
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:HENDRICKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BETH HENDRICKS
Mailing Address - Street 1:1649 NELEIGH DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88007-1985
Mailing Address - Country:US
Mailing Address - Phone:575-571-1302
Mailing Address - Fax:
Practice Address - Street 1:923 9TH ST STE B
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6431
Practice Address - Country:US
Practice Address - Phone:575-488-2720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM84537363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health