Healthcare Provider Details

I. General information

NPI: 1942818893
Provider Name (Legal Business Name): ANNE HINLEY MS, LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2020
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 S 390 E
SALT LAKE CITY UT
84107-2809
US

IV. Provider business mailing address

15218 W SKY HAWK DR
SUN CITY WEST AZ
85375-6508
US

V. Phone/Fax

Practice location:
  • Phone: 815-236-7085
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number12341001-4810
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: