Provider Demographics
NPI:1851756712
Name:HINCKLEY, KRISTI NICOLE (OTR)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:NICOLE
Last Name:HINCKLEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:NICOLE
Other - Last Name:KUBRICHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1353 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-3512
Mailing Address - Country:US
Mailing Address - Phone:904-566-1287
Mailing Address - Fax:
Practice Address - Street 1:1353 1ST AVE N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-3512
Practice Address - Country:US
Practice Address - Phone:904-566-1287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-20
Last Update Date:2015-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17462225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist