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NPI 1750356952

NPI 1750356952 : KRISTI R HINNERICHS ATC, CSCS : WAYNE, NE

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General NPI Number Information
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    NPI Number           |    1750356952
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    Entity Type          |    Individual 
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    Provider Name        |    KRISTI R HINNERICHS ATC, CSCS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/21/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1111 MAIN ST 
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    City                 |    WAYNE
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    State                |    NE
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    Zip                  |    68787-1181
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    Country              |    US
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    Telephone            |    402-375-7310
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    606 OAK DR 
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    City                 |    WAYNE
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    State                |    NE
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    Zip                  |    68787-1615
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    Country              |    US
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    Telephone            |    402-640-0061
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    319
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    License Number State |    NE
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