Provider Demographics
NPI:1053181792
Name:HINES, QUINIECIA M
Entity type:Individual
Prefix:
First Name:QUINIECIA
Middle Name:M
Last Name:HINES
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 1:6915 SIMMONS LN
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-9721
Mailing Address - Country:US
Mailing Address - Phone:703-927-5767
Mailing Address - Fax:
Practice Address - Street 1:4921 G ST SE APT 302
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5949
Practice Address - Country:US
Practice Address - Phone:703-927-5767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant