Provider Demographics
NPI:1194329912
Name:HINA, CHELSIE NICHOL
Entity type:Individual
Prefix:MISS
First Name:CHELSIE
Middle Name:NICHOL
Last Name:HINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 EASTMAN ST
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-4071
Mailing Address - Country:US
Mailing Address - Phone:740-819-0908
Mailing Address - Fax:
Practice Address - Street 1:1040 EASTMAN ST
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-4071
Practice Address - Country:US
Practice Address - Phone:740-819-0908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health