Provider Demographics
NPI:1811533003
Name:HINKLE, JODY LYNN
Entity type:Individual
Prefix:MRS
First Name:JODY
Middle Name:LYNN
Last Name:HINKLE
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 1:4948 S COUNTY ROAD 550 E
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:46135-7915
Mailing Address - Country:US
Mailing Address - Phone:317-727-3697
Mailing Address - Fax:765-653-1859
Practice Address - Street 1:821 INDIANAPOLIS RD
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:IN
Practice Address - Zip Code:46135-1451
Practice Address - Country:US
Practice Address - Phone:765-653-1606
Practice Address - Fax:765-653-1859
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ININ26017978A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist