Provider Demographics
NPI:1366754715
Name:HINOJOSA, KIM MARIE (FNP-C)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:MARIE
Last Name:HINOJOSA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:MARIE
Other - Last Name:PATENAUDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3066 E COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78220-1013
Mailing Address - Country:US
Mailing Address - Phone:210-233-7000
Mailing Address - Fax:210-277-6387
Practice Address - Street 1:8210 CALLAGHAN RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4775
Practice Address - Country:US
Practice Address - Phone:210-233-7000
Practice Address - Fax:210-348-9607
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP119166363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX214647403Medicaid