Provider Demographics
| NPI: | 1740530682 |
|---|---|
| Name: | HINES, ANGELIA (RRT) |
| Entity type: | Individual |
| Prefix: | |
| First Name: | ANGELIA |
| Middle Name: | |
| Last Name: | HINES |
| Suffix: | |
| Gender: | F |
| Credentials: | RRT |
| Other - Prefix: | |
| Other - First Name: | ANGELIA |
| Other - Middle Name: | |
| Other - Last Name: | WALLS |
| Other - Suffix: | |
| Other - Last Name Type: | Former Name |
| Other - Credentials: | |
| Mailing Address - Street 1: | 3601 S 6TH AVE |
| Mailing Address - Street 2: | |
| Mailing Address - City: | TUCSON |
| Mailing Address - State: | AZ |
| Mailing Address - Zip Code: | 85723-0001 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 520-792-1450 |
| Mailing Address - Fax: | 520-629-1779 |
| Practice Address - Street 1: | 3601 S 6TH AVE |
| Practice Address - Street 2: | |
| Practice Address - City: | TUCSON |
| Practice Address - State: | AZ |
| Practice Address - Zip Code: | 85723-0001 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 520-792-1450 |
| Practice Address - Fax: | 520-629-1779 |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2012-09-18 |
| Last Update Date: | 2012-09-18 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 227800000X, 2278C0205X, 2278E0002X, 2278E1000X, 2278G1100X, 2279C0205X, 2279E0002X, 2279E1000X, 2279G1100X | ||
| AZ | 010415 | 227900000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 227900000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | |
| No | 227800000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | |
| No | 2278C0205X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Critical Care |
| No | 2278E0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Emergency Care |
| No | 2278E1000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Educational |
| No | 2278G1100X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | General Care |
| No | 2279C0205X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Critical Care |
| No | 2279E0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Emergency Care |
| No | 2279E1000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Educational |
| No | 2279G1100X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | General Care |
