Basic Information
| Provider Information | |||||||||
| NPI: | 1710957188 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HINKER | ||||||||
| FirstName: | NATHAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CNP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 265 MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | CORSICA | ||||||||
| State: | SD | ||||||||
| PostalCode: | 573280028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6059465411 | ||||||||
| FaxNumber: | 6059465206 | ||||||||
| Practice Location | |||||||||
| Address1: | 265 MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | CORSICA | ||||||||
| State: | SD | ||||||||
| PostalCode: | 573280028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6059465411 | ||||||||
| FaxNumber: | 6059465206 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2006 | ||||||||
| LastUpdateDate: | 11/20/2009 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 0352 | SD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 5306742 | 05 | SD | MEDICAID | 6824102 | 01 | SD | MEDICAID NH | OTHER | S1639 | 01 | SD | MEDICARE PTAN | OTHER | 6693 | 01 | SD | AVERA HEALTH | OTHER | 4995919 | 01 | SD | WELLMARK | OTHER | P-11222864 | 01 | SD | MULTIPLAN | OTHER | 237243 | 01 | SD | MIDLAND'S CHOICE | OTHER | 01-14778 | 01 | SD | MEDICA | OTHER | 9237774 | 01 | SD | DAKOTACARE | OTHER | AH1141031593 | 01 | SD | PREFERRED ONE | OTHER |