Provider Demographics
NPI:1881276616
Name:HINES, GLORIA (CPM)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:HINES
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4021 E 115TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64137-2301
Mailing Address - Country:US
Mailing Address - Phone:816-882-2518
Mailing Address - Fax:
Practice Address - Street 1:13211 CRYSTAL AVE
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:MO
Practice Address - Zip Code:64030-3336
Practice Address - Country:US
Practice Address - Phone:816-535-0307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
21040016176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife