Provider Demographics
NPI:1891362893
Name:HINES, DENISE NISHA
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:NISHA
Last Name:HINES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4417 WHETSEL AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-2810
Mailing Address - Country:US
Mailing Address - Phone:513-284-6064
Mailing Address - Fax:
Practice Address - Street 1:4417 WHETSEL AVE APT 1
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-2810
Practice Address - Country:US
Practice Address - Phone:513-284-6064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHTU255692347C00000X
OH372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No347C00000XTransportation ServicesPrivate Vehicle