Provider Demographics
NPI:1366860629
Name:HINSON, JEFFERY TODD (RN, MS, MBA)
Entity Type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:TODD
Last Name:HINSON
Suffix:
Gender:M
Credentials:RN, MS, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 FULGHUM RD
Mailing Address - Street 2:
Mailing Address - City:EAST DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31027-1676
Mailing Address - Country:US
Mailing Address - Phone:478-484-2792
Mailing Address - Fax:
Practice Address - Street 1:675 FULGHUM RD
Practice Address - Street 2:
Practice Address - City:EAST DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31027-1676
Practice Address - Country:US
Practice Address - Phone:478-484-2792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN104920163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN104920OtherREGISTERED NURSE