Provider Demographics
NPI:1881814697
Name:HINER, PENNY DEANN (RN)
Entity Type:Individual
Prefix:
First Name:PENNY
Middle Name:DEANN
Last Name:HINER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5214 W COUNTY ROAD 300 S
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:47362-9724
Mailing Address - Country:US
Mailing Address - Phone:765-987-7646
Mailing Address - Fax:
Practice Address - Street 1:5214 W COUNTY ROAD 300 S
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:IN
Practice Address - Zip Code:47362-9724
Practice Address - Country:US
Practice Address - Phone:765-987-7646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28100457A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse