Healthcare Provider Details

I. General information

NPI: 1487879474
Provider Name (Legal Business Name): S GAYLE HINKLE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 06/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 FINANCIAL PL STE 100
ELIZABETHTOWN KY
42701-4470
US

IV. Provider business mailing address

103 FINANCIAL PL STE 100
ELIZABETHTOWN KY
42701-4470
US

V. Phone/Fax

Practice location:
  • Phone: 270-769-0110
  • Fax: 270-765-6953
Mailing address:
  • Phone: 270-769-0110
  • Fax: 270-765-6953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number4208P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: