Provider Demographics
NPI:1598356214
Name:HINKLE, TERESA (RN)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:HINKLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8021 S PARK AVE
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:AL
Mailing Address - Zip Code:36301-0780
Mailing Address - Country:US
Mailing Address - Phone:334-790-1525
Mailing Address - Fax:
Practice Address - Street 1:1955 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3015
Practice Address - Country:US
Practice Address - Phone:334-794-7798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-141294163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice