Individual
MARIANA ISABEL CORPUS HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
818 FOREST LN, WATERFORD, WI 53185-4585
(262) 514-8199
(262) 514-3851
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
16422
WI
363LF0000X
Family Nurse Practitioner
11020982
FL
363LF0000X
Family Nurse Practitioner
5019446
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100333585
—
WI
05
—
1730898396
—
NC
Enumeration date
11/22/2022
Last updated
10/14/2025
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