Individual
CLINT SHAWN PINKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RNFA
Contact information
Practice address
750 BRUNSWICK AVE, TRENTON, NJ 08638-4143
(903) 614-1000
Mailing address
PO BOX 11219, FORT WORTH, TX 76110-0219
(817) 294-7444
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
680751
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0083KE
BCBS
TX
Enumeration date
10/25/2006
Last updated
09/28/2011
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