Provider Demographics
NPI:1306122684
Name:HINKLEY, STEPHANIE A (RPH)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:A
Last Name:HINKLEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8601 STOLT RD
Mailing Address - Street 2:
Mailing Address - City:CHARLEVOIX
Mailing Address - State:MI
Mailing Address - Zip Code:49720-9086
Mailing Address - Country:US
Mailing Address - Phone:231-547-9113
Mailing Address - Fax:231-547-9113
Practice Address - Street 1:1500 BRIDGE ST
Practice Address - Street 2:ATTN: PHARMACY
Practice Address - City:CHARLEVOIX
Practice Address - State:MI
Practice Address - Zip Code:49720-9763
Practice Address - Country:US
Practice Address - Phone:231-547-1356
Practice Address - Fax:231-547-2132
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302021946183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist