MEDICARE: ALEX HINRICHSEN AGPCNP-BC

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	363LP2300X	Primary Care Nurse Practitioner	4704336328	MI

General Provider Information

NPI Number	:	1336623164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX HINRICHSEN AGPCNP-BC

Provider Business Mailing Address
First Line	:	333 HOUSTON AVE
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49441-1910
Country	:	US
Telephone Number	:	712-253-3877
Fax Number	:

Provider Business Practice Location Address
First Line	:	1050 W WESTERN AVE STE 400
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49441-1666
Country	:	US
Telephone Number	:	231-728-3442
Fax Number	:

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

Provider Enumeration Date	:	09/18/2018
Last Update Date	:	09/18/2018

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