Provider Demographics
NPI:1619719473
Name:HINTON, NICOLE MONIQUE (PRN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:MONIQUE
Last Name:HINTON
Suffix:
Gender:F
Credentials:PRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 SW 83RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-2133
Mailing Address - Country:US
Mailing Address - Phone:754-215-4294
Mailing Address - Fax:
Practice Address - Street 1:1760 SW 83RD AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-2133
Practice Address - Country:US
Practice Address - Phone:754-215-4294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11031683363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner