Provider Demographics
NPI:1588920201
Name:HINSON MEEK, KATHLEEN E (PA)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:E
Last Name:HINSON MEEK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:E
Other - Last Name:HINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:607 S NEW BALLAS RD STE 2300
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8234
Mailing Address - Country:US
Mailing Address - Phone:314-251-6394
Mailing Address - Fax:
Practice Address - Street 1:607 S NEW BALLAS RD STE 2300
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8234
Practice Address - Country:US
Practice Address - Phone:314-251-6394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-06
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021020067363A00000X, 363A00000X
MN1694363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNENROLLEDMedicaid
MN970006036Medicare PIN