Provider Demographics
NPI:1306997218
Name:HACKNEY, TINA (MSN, FNP)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:HACKNEY
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1238 HUFFMAN MILL RD
Mailing Address - Street 2:ROOM 127
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8700
Mailing Address - Country:US
Mailing Address - Phone:336-538-7482
Mailing Address - Fax:336-586-9101
Practice Address - Street 1:1238 HUFFMAN MILL RD
Practice Address - Street 2:ROOM 127
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8700
Practice Address - Country:US
Practice Address - Phone:336-538-7482
Practice Address - Fax:336-586-9101
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC79051363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily