Provider Demographics
NPI:1972555985
Name:HINTON, TERRI JO (PA)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:JO
Last Name:HINTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:JO
Other - Last Name:WELCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15435 WEST 134TH PLACE
Mailing Address - Street 2:STE 103
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062
Mailing Address - Country:US
Mailing Address - Phone:913-782-7515
Mailing Address - Fax:913-782-2942
Practice Address - Street 1:15435 WEST 134TH PLACE
Practice Address - Street 2:STE 103
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062
Practice Address - Country:US
Practice Address - Phone:913-782-7515
Practice Address - Fax:913-782-2942
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1500884363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS033C142DMedicare ID - Type Unspecified
P75422Medicare UPIN