Provider Demographics
NPI:1154658789
Name:HINKLE, PEGGY MARIE (IBCLC, PCD(DONA))
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:MARIE
Last Name:HINKLE
Suffix:
Gender:F
Credentials:IBCLC, PCD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 REGENT ST
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4628
Mailing Address - Country:US
Mailing Address - Phone:510-504-9413
Mailing Address - Fax:
Practice Address - Street 1:1312 REGENT ST
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4628
Practice Address - Country:US
Practice Address - Phone:510-504-9413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11146488OtherIBLCE