Provider Demographics
NPI:1528035342
Name:HINTZ, LAURA J (FNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:J
Last Name:HINTZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 MIDLAND RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638
Mailing Address - Country:US
Mailing Address - Phone:989-799-4840
Mailing Address - Fax:989-799-4994
Practice Address - Street 1:1740 MIDLAND RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638
Practice Address - Country:US
Practice Address - Phone:989-799-4840
Practice Address - Fax:989-799-4994
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704195930363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N69960Medicare ID - Type Unspecified
P86205Medicare UPIN