Provider Demographics
NPI:1205527702
Name:HINCHMAN, TINA M (LDN)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:M
Last Name:HINCHMAN
Suffix:
Gender:F
Credentials:LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CONSTITUTION SQ
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3546
Mailing Address - Country:US
Mailing Address - Phone:443-974-7173
Mailing Address - Fax:
Practice Address - Street 1:15 CONSTITUTION SQ
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3546
Practice Address - Country:US
Practice Address - Phone:443-974-7173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX6102133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist