Provider Demographics
NPI:1982642542
Name:HINSHAW, CHERYL I (CNM)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:I
Last Name:HINSHAW
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 568
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:OR
Mailing Address - Zip Code:97495-0568
Mailing Address - Country:US
Mailing Address - Phone:541-677-4427
Mailing Address - Fax:541-677-6522
Practice Address - Street 1:2460 NW STEWART PKWY
Practice Address - Street 2:SUITE 240
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-1516
Practice Address - Country:US
Practice Address - Phone:541-677-4427
Practice Address - Fax:541-677-6522
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR363LX0001X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR100347Medicaid
P91114Medicare UPIN
OR100347Medicaid