Provider Demographics
NPI:1609201839
Name:HINKES, TABITHA MIA (NP)
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:MIA
Last Name:HINKES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:TABITHA
Other - Middle Name:MIA
Other - Last Name:VAN PELT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:310 LEXINGTON AVE
Mailing Address - Street 2:APT 13D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3161
Mailing Address - Country:US
Mailing Address - Phone:240-449-9791
Mailing Address - Fax:
Practice Address - Street 1:550 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-5279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY430748363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care