Basic Information
| Provider Information | |||||||||
| NPI: | 1780760702 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HENDRIX | ||||||||
| FirstName: | NNEKA | ||||||||
| MiddleName: | AVERY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 19305 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282199305 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1801 ROZZELLES FERRY RD | ||||||||
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| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282084228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7044469987 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2006 | ||||||||
| LastUpdateDate: | 09/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 9801153 | NC | N | Allopathic & Osteopathic Physicians | General Practice | 207Q00000X | 9801153 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.