Provider Demographics
NPI:1487804043
Name:HINES, JUDY FRANKS (APN)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:FRANKS
Last Name:HINES
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E. UNIVERSITY,
Mailing Address - Street 2:REYNOLDS, SUITE 215
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71754-9210
Mailing Address - Country:US
Mailing Address - Phone:870-235-5237
Mailing Address - Fax:870-235-6354
Practice Address - Street 1:100 E UNIVERSITY
Practice Address - Street 2:REYNOLDS, SUITE 215
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753-2181
Practice Address - Country:US
Practice Address - Phone:870-235-5237
Practice Address - Fax:870-235-6354
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01401363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology