Healthcare Provider Details

I. General information

NPI: 1306905708
Provider Name (Legal Business Name): CHRISTINA D HINES CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 03/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 AMALIA DR
BUCKHANNON WV
26201-2239
US

IV. Provider business mailing address

1 AMALIA DR
BUCKHANNON WV
26201-2239
US

V. Phone/Fax

Practice location:
  • Phone: 304-472-7473
  • Fax: 304-472-0533
Mailing address:
  • Phone: 304-472-7473
  • Fax: 304-472-0533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberWV127
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: