Provider Demographics
NPI:1225778228
Name:HINKLE, LEANDRA RENAE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:LEANDRA
Middle Name:RENAE
Last Name:HINKLE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:LEANDRA
Other - Middle Name:RENAE
Other - Last Name:KIRK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1609 W 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:WV
Mailing Address - Zip Code:25661-3006
Mailing Address - Country:US
Mailing Address - Phone:304-235-0026
Mailing Address - Fax:
Practice Address - Street 1:1609 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:WV
Practice Address - Zip Code:25661-3006
Practice Address - Country:US
Practice Address - Phone:304-235-0026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV38621164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse