Provider Demographics
NPI:1386000776
Name:HINKLE, STACY (RN,BSN,CDE)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:HINKLE
Suffix:
Gender:F
Credentials:RN,BSN,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 DUBOIS ST
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-1048
Mailing Address - Country:US
Mailing Address - Phone:812-885-8010
Mailing Address - Fax:812-885-8754
Practice Address - Street 1:615 DUBOIS ST
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1048
Practice Address - Country:US
Practice Address - Phone:812-885-8010
Practice Address - Fax:812-885-8754
Is Sole Proprietor?:No
Enumeration Date:2016-01-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28113063A163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator