Healthcare Provider Details

I. General information

NPI: 1972155828
Provider Name (Legal Business Name): MICHELLE ELIZABETH HINKEY FNP-BC, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2019
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8109 RITCHIE HWY # 100
PASADENA MD
21122-6917
US

IV. Provider business mailing address

8109 RITCHIE HWY STE 100
PASADENA MD
21122-6917
US

V. Phone/Fax

Practice location:
  • Phone: 443-270-8600
  • Fax: 443-270-8990
Mailing address:
  • Phone: 442-270-8600
  • Fax: 443-270-8990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR186354
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: