Provider Demographics
NPI:1316643729
Name:HINKLE, KELLI A X
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:A
Last Name:HINKLE
Suffix:X
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 1:659 COUNTY ROAD 2404
Mailing Address - Street 2:
Mailing Address - City:LOUDONVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44842-9642
Mailing Address - Country:US
Mailing Address - Phone:614-949-1684
Mailing Address - Fax:
Practice Address - Street 1:659 COUNTY ROAD 2402
Practice Address - Street 2:
Practice Address - City:LOUDONVILLE
Practice Address - State:OH
Practice Address - Zip Code:44842
Practice Address - Country:US
Practice Address - Phone:614-949-1684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty