Provider Demographics
NPI:1326872854
Name:HINTZ, JODI
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:HINTZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:
Other - Last Name:KINGSBURY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4380 22ND ST SW
Mailing Address - Street 2:
Mailing Address - City:HANNOVER
Mailing Address - State:ND
Mailing Address - Zip Code:58563-9174
Mailing Address - Country:US
Mailing Address - Phone:701-301-9469
Mailing Address - Fax:
Practice Address - Street 1:4351 22ND ST SW
Practice Address - Street 2:
Practice Address - City:HANNOVER
Practice Address - State:ND
Practice Address - Zip Code:58563-9174
Practice Address - Country:US
Practice Address - Phone:701-794-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-27
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemaker
No372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty