Provider Demographics
NPI:1427033273
Name:HINDS, AUDREY L (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:AUDREY
Middle Name:L
Last Name:HINDS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6414 GREENOCK DR
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-6088
Mailing Address - Country:US
Mailing Address - Phone:770-413-7374
Mailing Address - Fax:
Practice Address - Street 1:ATLANTA VA MEDICAL CENTER
Practice Address - Street 2:1670 CLAIRMONT ROAD
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033
Practice Address - Country:US
Practice Address - Phone:404-321-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN059634363LA2200X
GARN 174977 NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health