Provider Demographics
NPI:1417287772
Name:HINKLE, ALICIA FAITH (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:FAITH
Last Name:HINKLE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:ALICIA
Other - Middle Name:FAITH
Other - Last Name:HINKLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:425 COLE ST
Mailing Address - Street 2:APT 408
Mailing Address - City:WAUSEON
Mailing Address - State:OH
Mailing Address - Zip Code:43567-1093
Mailing Address - Country:US
Mailing Address - Phone:567-454-0488
Mailing Address - Fax:
Practice Address - Street 1:425 COLE ST
Practice Address - Street 2:APT 408
Practice Address - City:WAUSEON
Practice Address - State:OH
Practice Address - Zip Code:43567-1093
Practice Address - Country:US
Practice Address - Phone:567-454-0488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-10
Last Update Date:2010-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.121565IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse