Healthcare Provider Details

I. General information

NPI: 1417798422
Provider Name (Legal Business Name): NINA KINSER APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 07/27/2025
Certification Date: 07/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 MCINTOSH CIR STE 200
JOPLIN MO
64804-3604
US

IV. Provider business mailing address

3401 MCINTOSH CIR
JOPLIN MO
64804-3651
US

V. Phone/Fax

Practice location:
  • Phone: 417-347-3703
  • Fax: 417-347-3727
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2025020571
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number228695
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: