Provider Demographics
NPI:1699091694
Name:HINDS, JEANNINE LAVONNE (MD, LAC)
Entity type:Individual
Prefix:MRS
First Name:JEANNINE
Middle Name:LAVONNE
Last Name:HINDS
Suffix:
Gender:F
Credentials:MD, LAC
Other - Prefix:MS
Other - First Name:JEANNINE
Other - Middle Name:LAVONNE
Other - Last Name:DANDRIDGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8485 E MCDONALD DR # 214
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-6335
Mailing Address - Country:US
Mailing Address - Phone:312-363-7250
Mailing Address - Fax:936-244-4643
Practice Address - Street 1:3501 N SCOTTSDALE RD STE 280
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5650
Practice Address - Country:US
Practice Address - Phone:312-363-7250
Practice Address - Fax:936-244-4643
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ48018207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine