Provider Demographics
NPI:1215544531
Name:HINKE, KRISTIN MARIE
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MARIE
Last Name:HINKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:MARIE
Other - Last Name:DORNFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4635 NICOLS RD UNIT 104
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-3337
Mailing Address - Country:US
Mailing Address - Phone:651-900-2210
Mailing Address - Fax:612-448-9105
Practice Address - Street 1:4635 NICOLS RD UNIT 104
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-3337
Practice Address - Country:US
Practice Address - Phone:651-900-2210
Practice Address - Fax:612-900-2210
Is Sole Proprietor?:No
Enumeration Date:2020-09-30
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician