Audrey Lyn Hendricks-Elliston

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

296537-1 Issued in NY

Practice address

3511 Barnes Ave
Tilden Towers 1 Apt 6G
Bronx, NY 10467-6031

Phone

(718) 519-0515

Fax

(718) 519-0515

NPI assigned

Mar 2, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1861852956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1103",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104660563",
            "telephone_number": "718-519-0515",
            "fax_number": "718-519-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 BARNES AVE",
            "address_2": "TILDEN TOWERS 1 APT 6G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104676031",
            "telephone_number": "718-519-0515",
            "fax_number": "718-519-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS-ELLISTON",
        "first_name": "AUDREY",
        "middle_name": "LYN",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-02",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "296537-1",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "2965371",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosa Henao
• Earlena Henderson
• Monique Denise Henderson, LMSW
• Rosalind Claire Henderson, MD MPH PHD
• Sarah Marie Henderson, MS
• Camille Imani Hendricks, RN
• Mallory Annette Hendricks, M.S.E.D.
• Tamara Hendricks, REGISTERED NURSE
• Eltha M Hendrickson, REGISTERED NURSE
• Yvette Hendrickson

• Licensed Practical Nurse in Bronx, NY
• Providers in Bronx, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.