Healthcare Provider Details

I. General information

NPI: 1851096507
Provider Name (Legal Business Name): SHEENANNE YVONNE HINKLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2687 N MEMORIAL DR
LANCASTER OH
43130-1670
US

IV. Provider business mailing address

2687 N MEMORIAL DR
LANCASTER OH
43130-1670
US

V. Phone/Fax

Practice location:
  • Phone: 740-687-0530
  • Fax: 740-687-0588
Mailing address:
  • Phone: 740-687-0530
  • Fax: 740-687-0588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberOP10145SC
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: