Healthcare Provider Details

I. General information

NPI: 1326619040
Provider Name (Legal Business Name): MADISON ALAINE KINSEY MS, LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2021
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 SPORTS CENTER DR
LEXINGTON KY
40502
US

IV. Provider business mailing address

4030 TATES CREEK RD APT 5613
LEXINGTON KY
40517-3193
US

V. Phone/Fax

Practice location:
  • Phone: 859-257-6521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: