Provider Demographics
NPI:1710957188
Name:HINKER, NATHAN (CNP)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:
Last Name:HINKER
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CORSICA
Mailing Address - State:SD
Mailing Address - Zip Code:57328-0028
Mailing Address - Country:US
Mailing Address - Phone:605-946-5411
Mailing Address - Fax:605-946-5206
Practice Address - Street 1:265 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CORSICA
Practice Address - State:SD
Practice Address - Zip Code:57328-0028
Practice Address - Country:US
Practice Address - Phone:605-946-5411
Practice Address - Fax:605-946-5206
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0352363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5306742Medicaid
SD6824102OtherMEDICAID NH
SDS1639OtherMEDICARE PTAN
SD6693OtherAVERA HEALTH
SD4995919OtherWELLMARK
SDP-11222864OtherMULTIPLAN
SD237243OtherMIDLAND'S CHOICE
SD01-14778OtherMEDICA
SD9237774OtherDAKOTACARE
SDAH1141031593OtherPREFERRED ONE
SD6824102OtherMEDICAID NH
SDP63162Medicare UPIN