Individual
ANNE T HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
7910 W JEFFERSON BLVD, SUITE 102, FORT WAYNE, IN 46804-4159
(260) 436-2424
(260) 436-2922
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3514
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000159A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970014263
RR MEDICARE
IN
Enumeration date
08/11/2005
Last updated
09/23/2020
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