Provider Demographics
NPI:1083315428
Name:HINMAN, CHAD MICHAEL
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:MICHAEL
Last Name:HINMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 1ST AVE W
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-4216
Mailing Address - Country:US
Mailing Address - Phone:701-774-8761
Mailing Address - Fax:
Practice Address - Street 1:1304 1ST AVE W
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-4216
Practice Address - Country:US
Practice Address - Phone:701-774-8761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider