Provider Demographics
NPI:1790907053
Name:HINKLE, AMANDA S (RD, CD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:S
Last Name:HINKLE
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8631 SPRINGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MC CORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-6157
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9084 TECHNOLOGY DR
Practice Address - Street 2:SUITE 500
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-3080
Practice Address - Country:US
Practice Address - Phone:317-570-1944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN919172133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered