Provider Demographics
NPI:1356346456
Name:HINNEN, DEBORAH A (APN)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:A
Last Name:HINNEN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 S UNION BLVD STE 305
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3126
Mailing Address - Country:US
Mailing Address - Phone:719-365-8650
Mailing Address - Fax:719-365-6877
Practice Address - Street 1:175 S UNION BLVD STE 305
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3126
Practice Address - Country:US
Practice Address - Phone:719-365-8650
Practice Address - Fax:719-365-6877
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO APN0991127 NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200407430AMedicaid
KS200407430AMedicaid
KS200407430AMedicaid