Healthcare Provider Details

I. General information

NPI: 1659784163
Provider Name (Legal Business Name): JENNIFER ASHLEY KINCAID
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2014
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MONUMENT RD STE 100
YORK PA
17403-5050
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-812-7500
  • Fax: 717-848-2074
Mailing address:
  • Phone: 717-851-1405
  • Fax: 717-851-6969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberMD479312
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: