Provider Demographics
NPI:1750631529
Name:HINKEBEIN, JEANNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:
Last Name:HINKEBEIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 WELLS RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42345-3360
Mailing Address - Country:US
Mailing Address - Phone:270-791-0194
Mailing Address - Fax:
Practice Address - Street 1:BLANCHFIELD COMMUNITY ARMY HOSPITAL
Practice Address - Street 2:650 JOEL DRIVE
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223-5349
Practice Address - Country:US
Practice Address - Phone:270-461-1563
Practice Address - Fax:270-461-4530
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1310103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30602015Medicaid