Healthcare Provider Details

I. General information

NPI: 1689984767
Provider Name (Legal Business Name): JESSICA H KINKELA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA KINKELA

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 ARMSTRONG RD
BATTLE CREEK MI
49037-7314
US

IV. Provider business mailing address

5500 ARMSTRONG RD
BATTLE CREEK MI
49037-7314
US

V. Phone/Fax

Practice location:
  • Phone: 269-966-5600
  • Fax:
Mailing address:
  • Phone: 269-966-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number6301014760
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301014760
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: