MEDICARE: PATRICIA LEA HINES NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP3-0004103	WA
2	363LF0000X	Family Nurse Practitioner	NP329A	HI

General Provider Information

NPI Number	:	1023114758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA LEA HINES NP

Provider Business Mailing Address
First Line	:	10914 E 23RD AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-5636
Country	:	US
Telephone Number	:	509-821-5172
Fax Number	:	509-892-5172

Provider Business Practice Location Address
First Line	:	702 E SHARP AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99258-0001
Country	:	US
Telephone Number	:	509-323-4052
Fax Number	:	509-323-5516

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	07/08/2007

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