Provider Demographics
NPI:1548994650
Name:HINDMAN, ABIGAIL MILLICENT
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MILLICENT
Last Name:HINDMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1838 SW FEARS AVE
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-4526
Mailing Address - Country:US
Mailing Address - Phone:772-408-3480
Mailing Address - Fax:
Practice Address - Street 1:1838 SW FEARS AVE
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-4526
Practice Address - Country:US
Practice Address - Phone:772-408-3480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11020942363LA2100X
FLRN9342710163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WG0600XNursing Service ProvidersRegistered NurseGerontology