Provider Demographics
NPI:1043635915
Name:HINZMAN, BRITTANY (COTA)
Entity type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:
Last Name:HINZMAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 KENTON ST
Mailing Address - Street 2:
Mailing Address - City:BROMLEY
Mailing Address - State:KY
Mailing Address - Zip Code:41016-1230
Mailing Address - Country:US
Mailing Address - Phone:859-496-8777
Mailing Address - Fax:
Practice Address - Street 1:231 KENTON ST
Practice Address - Street 2:
Practice Address - City:BROMLEY
Practice Address - State:KY
Practice Address - Zip Code:41016-1230
Practice Address - Country:US
Practice Address - Phone:859-496-8777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH04785172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker