Luann T Hinnenkamp
Individual provider Active NPI Driver · Fargo, ND
NPI 1164717005 · NPPES record last updated Jun 17, 2011
Key facts
- NPI
- 1164717005
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- HIN-58-6702 (ND)
- Practice address
- 3018 36TH Ave S
Fargo, ND 58104-8844 - Phone
- (701) 298-8285
- NPI assigned
- Jun 17, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HIN-58-6702 | ND | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | HIN-58-6702 | ND | Yes |
Addresses
Primary practice location
3018 36TH Ave S
Fargo, ND 58104-8844
Mailing address
3018 36TH Ave S
Fargo, ND 58104-8844
Phone (701) 298-8285
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.