Provider Demographics
NPI:1427679448
Name:HINKLE, RICHARD T (CNA, EMT)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:T
Last Name:HINKLE
Suffix:
Gender:M
Credentials:CNA, EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2798 S 50 W
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-6464
Mailing Address - Country:US
Mailing Address - Phone:405-762-3242
Mailing Address - Fax:
Practice Address - Street 1:401 S 400 E
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-4933
Practice Address - Country:US
Practice Address - Phone:801-295-2361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2019032375146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic