Provider Demographics
NPI:1255658290
Name:HINKLE, AMANDA E (APRN - FNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:E
Last Name:HINKLE
Suffix:
Gender:F
Credentials:APRN - FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:386 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:CHAPMANVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25508-9202
Mailing Address - Country:US
Mailing Address - Phone:304-855-1200
Mailing Address - Fax:304-855-1230
Practice Address - Street 1:386 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:CHAPMANVILLE
Practice Address - State:WV
Practice Address - Zip Code:25508-9202
Practice Address - Country:US
Practice Address - Phone:304-855-1200
Practice Address - Fax:304-855-1230
Is Sole Proprietor?:No
Enumeration Date:2010-04-30
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV66795363LF0000X
WVAPRN66795363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810017408Medicaid