Individual
ELICIA HINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3306 W ROOSEVELT ST, PHOENIX, AZ 85009-3404
(602) 889-9401
Mailing address
3306 W ROOSEVELT ST, PHOENIX, AZ 85009-3404
(602) 889-9401
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN201036
AZ
363LF0000X
Family Nurse Practitioner
Primary
235003
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008602
—
AZ
Enumeration date
11/23/2019
Last updated
03/23/2022
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