Healthcare Provider Details

I. General information

NPI: 1154168300
Provider Name (Legal Business Name): GABRIELLE M HINSHAW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5210 ADELLA ST
TOLEDO OH
43613-2706
US

IV. Provider business mailing address

5210 ADELLA ST
TOLEDO OH
43613-2706
US

V. Phone/Fax

Practice location:
  • Phone: 419-450-6336
  • Fax:
Mailing address:
  • Phone: 419-450-6336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: