Healthcare Provider Details

I. General information

NPI: 1568395705
Provider Name (Legal Business Name): ROBIN REBECCA HINCKLEY MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W FORT ST
BOISE ID
83702-4501
US

IV. Provider business mailing address

615 SE BRIDGEWAY AVE
CORVALLIS OR
97333-1230
US

V. Phone/Fax

Practice location:
  • Phone: 208-422-1000
  • Fax:
Mailing address:
  • Phone: 253-414-2653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10061189
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: