Provider Demographics
NPI:1568446425
Name:HINTZE, LUANN MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:LUANN
Middle Name:MARIE
Last Name:HINTZE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LUANN
Other - Middle Name:MARIE
Other - Last Name:SCHMIDTHUBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1108 1ST ST SE
Mailing Address - Street 2:LITTLE FALLS ORTHOPEDICS
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-3440
Mailing Address - Country:US
Mailing Address - Phone:320-631-2200
Mailing Address - Fax:320-632-3728
Practice Address - Street 1:1108 1ST ST SE
Practice Address - Street 2:LITTLE FALLS ORTHOPEDICS
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-3440
Practice Address - Country:US
Practice Address - Phone:320-631-2200
Practice Address - Fax:320-632-3728
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9713363A00000X
WI2506363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN403214400Medicaid
MN403214400Medicaid
P53134Medicare UPIN