Provider Demographics
NPI:1912463316
Name:HINKLE, LEIGH ANN
Entity Type:Individual
Prefix:MS
First Name:LEIGH
Middle Name:ANN
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 1:4403 MADISON AVE LOT 60
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-3793
Mailing Address - Country:US
Mailing Address - Phone:463-206-3010
Mailing Address - Fax:
Practice Address - Street 1:4403 MADISON AVE LOT 60
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-3793
Practice Address - Country:US
Practice Address - Phone:463-206-3010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN900-620-109374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty