Provider Demographics
NPI:1023162021
Name:HINES, DENNIS M (NP)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:M
Last Name:HINES
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 OCEAN ST
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-4906
Mailing Address - Country:US
Mailing Address - Phone:866-389-2727
Mailing Address - Fax:401-652-9787
Practice Address - Street 1:1880 OCEAN ST
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-4906
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:401-652-9787
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2016-11-29
Deactivation Date:2015-10-26
Deactivation Code:
Reactivation Date:2015-10-26
Provider Licenses
StateLicense IDTaxonomies
MA149531363LF0000X
HIAPRN1939363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000879702Medicare PIN
MA000879701Medicare PIN