Provider Demographics
NPI:1376828749
Name:HINKLEY, GENEVIEVE ELAINA (PA-C)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:ELAINA
Last Name:HINKLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D235BBC
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:44199 DEQUINDRE RD # 509
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1128
Practice Address - Country:US
Practice Address - Phone:248-964-1920
Practice Address - Fax:248-964-1921
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2022-07-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601006109363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant