Provider Demographics
NPI:1790349579
Name:HINES, DONNA LYNNETTE (MEDICAL ASSISTANT)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:LYNNETTE
Last Name:HINES
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 PROVIDENCE ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-1706
Mailing Address - Country:US
Mailing Address - Phone:202-706-0554
Mailing Address - Fax:
Practice Address - Street 1:1850 PROVIDENCE ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1706
Practice Address - Country:US
Practice Address - Phone:202-706-0554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-26
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty