Provider Demographics
NPI:1154818284
Name:HINTON, NANA
Entity Type:Individual
Prefix:
First Name:NANA
Middle Name:
Last Name:HINTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11000 HUNTINGTON MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-3440
Mailing Address - Country:US
Mailing Address - Phone:704-606-9243
Mailing Address - Fax:
Practice Address - Street 1:11000 HUNTINGTON MEADOW LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-3440
Practice Address - Country:US
Practice Address - Phone:704-606-9243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-14
Last Update Date:2018-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities