Healthcare Provider Details

I. General information

NPI: 1902628381
Provider Name (Legal Business Name): KRISTINE KINSEY CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29101 HEALTH CAMPUS DR
WESTLAKE OH
44145-5270
US

IV. Provider business mailing address

6100 MERRIWEATHER DR
COLUMBIA MD
21044-3486
US

V. Phone/Fax

Practice location:
  • Phone: 440-847-9956
  • Fax:
Mailing address:
  • Phone: 800-925-3368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0037981
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: