Provider Demographics
NPI:1518709351
Name:JOHNSON HINES, AALIYAH ASHLIE
Entity type:Individual
Prefix:
First Name:AALIYAH
Middle Name:ASHLIE
Last Name:JOHNSON HINES
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 1:12464 PARTRIDGE RUN DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-5008
Mailing Address - Country:US
Mailing Address - Phone:314-873-5667
Mailing Address - Fax:
Practice Address - Street 1:12464 PARTRIDGE RUN DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-5008
Practice Address - Country:US
Practice Address - Phone:314-873-5667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider