Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 004187 | AZ |
Y | 207QS0010X | Family Doctor - Sports Medicine | 004187 | AZ |
NPI | 1073515078 |
---|---|
Provider Name | Nina Patel-Hinkle |
First Address | Sun City, AZ 85351-3058 |
Second Address | Phoenix, AZ 85023-1266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 26/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5550830001 | DME SCW (01) | AZ |
5550830003 | DME PEORIA (01) | AZ |
5550830007 | DME NP (01) | AZ |
5550830010 | DME GILBERT (01) | AZ |
5550830013 | DME MESA (01) | AZ |
5550830014 | DME WEST VALLEY (01) | AZ |
902207 | (05) | AZ |