Healthcare Provider Details

I. General information

NPI: 1518697028
Provider Name (Legal Business Name): AMY SUZANNE HINER RN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 6TH STREET SW AIM OFFICE
CANTON OH
44710-4471
US

IV. Provider business mailing address

PO BOX 80690
CANTON OH
44708-0690
US

V. Phone/Fax

Practice location:
  • Phone: 330-361-2137
  • Fax:
Mailing address:
  • Phone: 330-363-7444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberAPRN.CNS.11964
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: