=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518697028
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMY SUZANNE HINER RN, CNS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/16/2022
-----------------------------------------------------
Last Update Date | 04/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2600 6TH STREET SW AIM OFFICE
-----------------------------------------------------
City | CANTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44710-4471
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-361-2137
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 80690
-----------------------------------------------------
City | CANTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44708-0690
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-363-7444
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 364SA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Clinical Nurse Specialist
-----------------------------------------------------
License Number | APRN.CNS.11964
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------