Provider Demographics
NPI:1669248605
Name:HINKEL, LAUREN NICOLE
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:NICOLE
Last Name:HINKEL
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 1:204 S NORWOOD ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63361-1958
Mailing Address - Country:US
Mailing Address - Phone:573-338-6920
Mailing Address - Fax:
Practice Address - Street 1:900 BURLINGTON ST
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63384-1114
Practice Address - Country:US
Practice Address - Phone:573-684-2047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012038623225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant