Provider Demographics
NPI:1679964407
Name:HENDRESS, CORTNEY (NP-C)
Entity type:Individual
Prefix:
First Name:CORTNEY
Middle Name:
Last Name:HENDRESS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 E MAIN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1393
Mailing Address - Country:US
Mailing Address - Phone:317-969-7227
Mailing Address - Fax:
Practice Address - Street 1:70 E MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1393
Practice Address - Country:US
Practice Address - Phone:317-969-7227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-16
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71005347A363LA2200X
IN28169560A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse