Healthcare Provider Details

I. General information

NPI: 1629986229
Provider Name (Legal Business Name): KELLY KINARD BSN, RN, CBS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 10TH ST NW
VERNON AL
35592-5829
US

IV. Provider business mailing address

1131 10TH ST NW
VERNON AL
35592-5829
US

V. Phone/Fax

Practice location:
  • Phone: 205-431-7650
  • Fax:
Mailing address:
  • Phone: 205-431-7650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number1-169071
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code163WR1000X
TaxonomyReproductive Endocrinology/Infertility Registered Nurse
License Number1-169071
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number1-169071
License Number StateAL
# 4
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number1-169071
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: