MEDICARE: JEANETTE LOUISE HINES

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	385H00000X	Respite Care		OH

General Provider Information

NPI Number	:	1073471728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANETTE LOUISE HINES

Provider Business Mailing Address
First Line	:	6304 FENCE ROW LN
Second Line	:
City	:	CANAL WINCHESTER
State	:	OH
Zip	:	43110-9789
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6304 FENCE ROW LN
Second Line	:
City	:	CANAL WINCHESTER
State	:	OH
Zip	:	43110-9789
Country	:	US
Telephone Number	:	614-649-7951
Fax Number	:

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	03/18/2026

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