Provider Demographics
NPI:1053039495
Name:HINZ, CHRISTINE SUSANNE (RN)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:SUSANNE
Last Name:HINZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2695 SHELDON DR
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46582-6544
Mailing Address - Country:US
Mailing Address - Phone:574-658-9455
Mailing Address - Fax:574-658-3412
Practice Address - Street 1:2695 SHELDON DR
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46582-6544
Practice Address - Country:US
Practice Address - Phone:574-658-9455
Practice Address - Fax:574-658-3412
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28199280A364SL0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SL0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistLong-Term Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN28199280AOtherN/A