Healthcare Provider Details

I. General information

NPI: 1932958261
Provider Name (Legal Business Name): ISABELLE COLETTE KINNEY RN, BSN, CCRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ISABELLE STREETER

II. Dates (important events)

Enumeration Date: 05/17/2024
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2039 HORNBECK CT
RALEIGH NC
27614-7095
US

IV. Provider business mailing address

2039 HORNBECK CT
RALEIGH NC
27614-7095
US

V. Phone/Fax

Practice location:
  • Phone: 919-923-1402
  • Fax:
Mailing address:
  • Phone: 919-923-1402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number329871
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: