Provider Demographics
NPI:1215612080
Name:HINOTE, MYANNE RAY (APRN)
Entity type:Individual
Prefix:
First Name:MYANNE
Middle Name:RAY
Last Name:HINOTE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MYANNE
Other - Middle Name:RAY
Other - Last Name:LIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4724 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2339
Mailing Address - Country:US
Mailing Address - Phone:850-696-4000
Mailing Address - Fax:850-434-2647
Practice Address - Street 1:161 E NINE MILE RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32534-3140
Practice Address - Country:US
Practice Address - Phone:850-696-4000
Practice Address - Fax:850-434-2647
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11026711363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily