Provider Demographics
NPI:1356931653
Name:HINKLE, CHRISTIANNA EMMA
Entity type:Individual
Prefix:
First Name:CHRISTIANNA
Middle Name:EMMA
Last Name:HINKLE
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 1:644 SUMATRA AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-1952
Mailing Address - Country:US
Mailing Address - Phone:330-221-1070
Mailing Address - Fax:
Practice Address - Street 1:695 MESA VERDE DR
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-8653
Practice Address - Country:US
Practice Address - Phone:330-221-1070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0397615Medicaid