Provider Demographics
NPI:1609069350
Name:HINNANT, MAE B (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MAE
Middle Name:B
Last Name:HINNANT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:MAE
Other - Middle Name:B
Other - Last Name:YOST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17816 SINTER WAY
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6392
Mailing Address - Country:US
Mailing Address - Phone:301-733-6741
Mailing Address - Fax:
Practice Address - Street 1:1425 PORTER ST
Practice Address - Street 2:
Practice Address - City:FORT DETRICK
Practice Address - State:MD
Practice Address - Zip Code:21702-9211
Practice Address - Country:US
Practice Address - Phone:301-619-7156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP41645164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse