Basic Information
| Provider Information | |||||||||
| NPI: | 1073515078 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL-HINKLE | ||||||||
| FirstName: | NINA | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10494 W THUNDERBIRD BLVD | ||||||||
| Address2: | STE 102 | ||||||||
| City: | SUN CITY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853513058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6235375600 | ||||||||
| FaxNumber: | 8669392673 | ||||||||
| Practice Location | |||||||||
| Address1: | 18444 N 25TH AVE | ||||||||
| Address2: | STE 310 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850231266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6232418622 | ||||||||
| FaxNumber: | 6235445531 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2005 | ||||||||
| LastUpdateDate: | 06/26/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 004187 | AZ | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QS0010X | 004187 | AZ | Y | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine |
ID Information
| ID | Type | State | Issuer | Description | 5550830007 | 01 | AZ | DME NP | OTHER | 5550830013 | 01 | AZ | DME MESA | OTHER | 5550830001 | 01 | AZ | DME SCW | OTHER | 902207 | 05 | AZ | MEDICAID | 5550830014 | 01 | AZ | DME WEST VALLEY | OTHER | 5550830010 | 01 | AZ | DME GILBERT | OTHER | 5550830003 | 01 | AZ | DME PEORIA | OTHER |