Individual
JANNYELL HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3002 BONDS AVE, SOUTH BEND, IN 46628-1931
(574) 381-0867
Mailing address
3002 BONDS AVE, SOUTH BEND, IN 46628-1931
(574) 381-0867
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
24-016873
IN
3747P1801X
Personal Care Attendant
24-016873
IN
376J00000X
Homemaker
Primary
24-016873
IN
Other
Enumeration date
04/08/2024
Last updated
10/06/2024
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