Provider Demographics
NPI:1972694438
Name:HEDRICK, FRANCES A (MD)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:A
Last Name:HEDRICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-7301
Mailing Address - Country:US
Mailing Address - Phone:208-746-1383
Mailing Address - Fax:208-746-6348
Practice Address - Street 1:2315 8TH ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-7301
Practice Address - Country:US
Practice Address - Phone:208-746-1383
Practice Address - Fax:208-746-6348
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM91-146207Q00000X
IDM7875207Q00000X
WAMD00038028207Q00000X
MOR8E66207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8246951Medicaid
ID000010005691OtherREGENCE BLUESHIELD
WA132598OtherWA LABOR & INDUSTRY
ID34199OtherBLUE CROSS
ID805544400OtherHEATHLY CONNECTIONS
ID1142664OtherDMERC
ID805544400Medicaid
ID841377860OtherMISCELLANEOUS INSURANCE
IDE89352Medicare UPIN
ID841377860OtherMISCELLANEOUS INSURANCE
ID34199OtherBLUE CROSS
80159532Medicare PIN