Provider Demographics
NPI:1275162596
Name:HINSHAW, JOY ELLEN (CHES, CCP)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:ELLEN
Last Name:HINSHAW
Suffix:
Gender:F
Credentials:CHES, CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 171
Mailing Address - Street 2:
Mailing Address - City:LOSANTVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47354-0171
Mailing Address - Country:US
Mailing Address - Phone:765-625-1284
Mailing Address - Fax:
Practice Address - Street 1:23 N CHERRY ST
Practice Address - Street 2:
Practice Address - City:LOSANTVILLE
Practice Address - State:IN
Practice Address - Zip Code:47354-9262
Practice Address - Country:US
Practice Address - Phone:765-625-1284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA33296174H00000X
IN37003831A133V00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA33296OtherNATIONAL COMMISSION FOR HEATH EDUCATION CREDENTIALING, INC