Provider Demographics
NPI:1720440753
Name:HIENTON, AMANDA MARIE (CNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:HIENTON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:781 BETA DR
Mailing Address - Street 2:STE F
Mailing Address - City:MAYFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2356
Mailing Address - Country:US
Mailing Address - Phone:440-919-0235
Mailing Address - Fax:440-919-0238
Practice Address - Street 1:6559 WILSON MILLS RD
Practice Address - Street 2:STE 106
Practice Address - City:MAYFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44143-6402
Practice Address - Country:US
Practice Address - Phone:440-449-1540
Practice Address - Fax:440-460-2833
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH18969363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner