Provider Demographics
NPI:1124331210
Name:HINZE, AMY LEE (ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LEE
Last Name:HINZE
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LEE
Other - Last Name:CALLAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 N HIGLEY RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-1604
Mailing Address - Country:US
Mailing Address - Phone:480-543-2034
Mailing Address - Fax:480-543-2647
Practice Address - Street 1:1900 N HIGLEY RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-1604
Practice Address - Country:US
Practice Address - Phone:480-543-2034
Practice Address - Fax:480-543-2647
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3723363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ147517Medicare PIN
AZZ139919Medicare PIN